Use of the Corail stem for revision total hip arthroplasty: evaluation of clinical outcomes and cost

Background: With the growing number of total hip arthroplasty (THA) procedures performed, revision surgery is also proportionately increasing, resulting in greater health care expenditures. The purpose of this study was to assess clinical outcomes and cost when using a collared, fully hydroxyapatite-coated primary femoral stem for revision THA compared to commonly used revision femoral stems.
Methods: We retrospectively identified patients who underwent revision THA with a primary stem between 2011 and 2016 and matched them on demographic variables and reason for revision to a similar cohort who underwent revision THA. We extracted operative data and information on in-hospital resource use from the patients’ charts to calculate average cost per procedure. Patient-reported outcomes were recorded preoperatively and 1 year postoperatively.
Results: We included 20 patients in our analysis, of whom 10 received a primary stem and 10, a typical revision stem. There were no significant between-group differences in mean Western Ontario and McMaster Universities Osteoarthritis Index score, Harris Hip Score, 12-Item Short Form Health Survey (SF-12) Mental Composite Scale score or Physical Composite Scale score at 1 year. Operative time was significantly shorter and total cost was significantly lower (mean difference –3707.64, 95% confidence interval –5532.85 to –1882.43) with a primary stem than with other revision femoral stems.
Conclusion: We found similar clinical outcomes and significant institutional cost savings with a primary femoral stem in revision THA. This suggests a role for a primary femoral stem such as a collared, fully hydroxyapatite-coated stem for revision THA.
Competing Interests: E. Vasarhelyi and B. Lanting have received consulting fees and research support from Smith & Nephew, DePuy Synthes and Stryker. No other competing interests declared.
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