Total Hip Replacement Revision in a Single Brand Small Cementless Stem – Our Experience after the Findings of the National Joint Registry

Background: Cementless total hip replacement is the common THR performed in England, Wales, Northern Irelandand the Isle of Man. The Corail stem is the most popular cementless implant and has a ODEP 10A rating. Review ofits performance in the registry identified an increase rate of revision amongst the smaller stem sizes. However, claritywas not provided on the explanation for this finding. We reviewed our own experience of smaller stems with a view tounderstanding the reasons for revision.Methods: We reviewed a single centre, single surgeon experience of the smaller Corail stem sizes for a ten-yearperiod from 2003 to 2013. All data was collected from a prospectively maintained database. Details of clinical andradiological follow up were collected for all patients who had Corail stem size 8 and 9 implanted. Revision for any causewas taken as our endpoint.Results: 542 patients underwent total hip arthroplasty using the Corail stem during the study period. 53 small sizeCorail stems were implanted. The average age was 59 (range 17-88 years) and the average follow up was 41.4 months(range 1-118 months). 6 patients underwent revision during the study period, but only 4 stems required revision.The reasons for revision were aseptic loosening, fracture and metal-on metal complications. Only two stems requiredrevision for stem related factors (3.8%).Conclusion: There was no evidence of an increased rate of revision in the small Corail stems in our cohort.