The Actis and Corail Femoral Stems Provide for Similar Clinical and Radiographic Outcomes in Total Hip Arthroplasty
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ORIGINAL ARTICLE
The Actis and Corail Femoral Stems Provide for Similar Clinical and Radiographic Outcomes in Total Hip Arthroplasty Stephanie V. Kaszuba, BS & Nancy Cipparrone, MA & Alexander C. Gordon, MD
Received: 24 April 2020/Accepted: 16 August 2020/ * Hospital for Special Surgery 2020
Abstract Background: The introduction of new devices for total hip arthroplasty (THA) offers surgeons the ability to address deficits in the portfolio. However, once introduced, data regarding the performance of devices is not publicly available until their use is widespread. Purpose/Questions: The objective of this study was to compare the clinical and radiographic performance, including patient reported outcomes and radiographic evidence of osseointegration, subsidence, and stress shielding, of the newer Actis femoral component to the Corail stem (DePuy Synthes, Warsaw, IN, USA), which has an extensive clinical history. Methods: This short-term, retrospective cohort study was a single surgeon series of 330 anterior approach THAs, consisting of 165 cases using the Actis stem and 165 cases using the Corail stem. Both devices were cementless, titanium, tapered, hydroxyapatite–coated stems. They differed in Level of Evidence: Level III: Therapeutic Study Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-020-09792-2) contains supplementary material, which is available to authorized users. S. V. Kaszuba, BS : N. Cipparrone, MA : A. C. Gordon, MD (*) Department of Orthopedic Surgery, Illinois Bone & Joint Institute, 9000 Waukegan Road, Suite 200, Morton Grove, IL 60053, USA e-mail: [email protected] S. V. Kaszuba, BS Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA A. C. Gordon, MD Department of Orthopedic Surgery, Advocate Lutheran General Hospital, Park Ridge, IL, USA A. C. Gordon, MD Department of Orthopedic Surgery, NorthShore Skokie Hospital, Skokie, IL, USA
geometry, neck choices, broach philosophy, and collar availability. Data was obtained for 1 year following THA. Functional outcomes were measured with the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS, JR.) survey. Complications were recorded from patient charts, and radiographic analysis was performed for signs of osseointegration, subsidence, and stress shielding. Results: The groups shared similar demographic characteristics except the Actis population was younger with fewer women. The complication rate did not significantly vary, and no patient required revision within the first year. Radiographically, one patient in each group demonstrated subsidence. No cases exhibited radiolucent lines, and the prevalence of stress shielding at 1 year was comparable. HOOS, JR. scores did not significantly vary at 8 weeks or 1 year. Conclusion: The Actis stem does not carry an increased risk of device-related complications compared with the Corail implant. Although aspects of bone remodeling differed between groups, Actis achieved radiographic signs
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