title: Fixation of the fully hydroxyapatite-coated Corail stem implanted due to femoral neck fracture: 38 patients followed for 2 years with RSA and DEXA.
abstract: BACKGROUND
  Today, dislocated femoral neck fractures are commonly treated with a cemented hip arthroplasty. However, cementing of the femoral component may lead to adverse effects and even death. Uncemented stems may lower these risks and hydroxyapatite (HA) coating may enhance integration, but prosthetic stability and clinical outcome in patients with osteoporotic bone have not been fully explored. We therefore studied fixation and clinical outcome in patients who had had a femoral neck fracture and who had received a fully HA-coated stem prosthesis.
  
  
  METHODS
  50 patients with a dislocated femoral neck fracture were operated with the fully HA-coated Corail total or hemiarthroplasty. 38 patients, mean age 81 (70-96) years, were followed for 24 months with conventional radiographs, RSA, DEXA, and for clinical outcome.
  
  
  RESULTS
  31 of the 38 implants moved statistically significantly up to 3 months, mainly distally, mean 2.7 mm (max. 20 mm (SD 4.3)), and rotated into retroversion mean 3.3º (-1.8 to 17) (SD 4.3) and then appeared to stabilize. Distal stem migration was more pronounced if the stem was deemed to be too small. There was no correlation between BMD and stem migration. The migration did not result in any clinically adverse effects.
  
  
  CONCLUSIONS
  The fully hydroxyapatite-coated Corail stem migrates during the first 3 months, but clinical outcome appears to be good, without any adverse events.
authors: Department of Orthopaedics, Lund University, Sweden. Thord.von_Schewelov@med.lu.se
authors: Thord von
authors: Tv
authors: Schewelov
authors: Henrik
authors: H
authors: Ahlborg
authors: Lennart
authors: L
authors: Sanzén
authors: Jack
authors: J
authors: Besjakov
authors: Ake
authors: A
authors: Carlsson
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D015519:Bone Density / Q000502:physiology; D017886:Durapatite; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D006622:Hip Prosthesis / Q000145:classification*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D059869:Radiostereometric Analysis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D017886:Durapatite