The Use of a High Offset Fully Coated Collarless Cementless Stem Does Not Result in Early Failures in Total Hip Arthroplasty

Introduction: The Corail femoral stem has excellent long-term survivorship in total hip arthroplasty (THA). However, there remains a paucity of information on the specific performance of the high offset collarless stem in relation to subsidence, loosening, offset, and failure rates. Methods: Retrospective data were collected on all consecutive high offset collarless Corail stems implanted at a single centre in the UK. Data included patient demographics, femoral Dorr classification, radiographic analysis for radiolucent lines, and stem subsidence. The postoperative femoral offset was measured against the native offset of the contralateral hip. Any early failures, re-operations, or requirements for revision surgery were recorded. Results: We identified 162 stems for inclusion in the study. Ninety-five patients were male. The mean age was 60.5 (40 to 78) years, and the mean BMI was 29.8 (21 to 50) kg/m(2). The mean length of follow-up was 84.5 (12-130) months. Subsidence was recorded on 113 (69.7%) stems. The mean amount of total stem subsidence in the whole cohort was 1.62mm (0 to 3.9mm). There was no correlation between the amount of subsidence and the preoperative Dorr classification, age, sex, BMI, or indication for surgery. Radiolucent lines were exclusively seen in stems paired with a large-diameter 36-mm femoral head. The high offset stem accurately reproduced native femoral offset; the mean difference in offset was -1.21mm (-24mm to +21mm). There were no early failures, re-operations, or revision surgeries. Conclusion: The use of a high offset stem can accurately reproduce native femoral offset when chosen for THA. The high offset collarless Corail stem does not result in early failures in THA, and we support its use.