Hip Pelvis.  2013 Sep;25(3):173-181. 10.5371/hp.2013.25.3.173.

Minimum Seven-year Follow-up of Cementless Total Hip Arthroplasty with the COREN Hip System

Affiliations
  • 1Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ysp3504@skku.edu
  • 2Department of Orthopaedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 3Department of Orthopaedic Surgery, Seoul St Mary's Hospital, Catholic University School of Medicine, Seoul, Korea.

Abstract

PURPOSE
We previously reported results of a mean 3.2-year follow-up of the COREN hip system, which is the first total hip prosthesis developed in Korea. The aim of this prospective study was to update the previous report with regard to the hip function and radiographic implant performance.
MATERIALS AND METHODS
Between 2003 and 2004, a consecutive series of 68 primary, cementless, total hip prostheses (COREN) were implanted in 57 patients(68 hips) and followed up for a minimum of 7 years. Sixty-three of the 68 hips were available for clinical scoring and radiographic analysis.
RESULTS
The mean Harris hip and WOMAC scores were improved from 48.1 and 54.7, preoperatively, to 96.4 and 22.1 at the final follow-up. The mean patient activity increased from 3.1, preoperatively, to 8.2 at the final follow-up. All hips showed stable bony ingrowth on the radiographs. No hips showed evidence of osteolysis or prosthesis loosening, and no revision was required during the follow-up. A Periprosthetic fracture (Vancouver type B1) was encountered in one hip 4.7 years after surgery, which was treated by reoperation.
CONCLUSION
This study shows that the COREN hip system produces excellent mid-term results in cementless hip arthroplasty.

Keyword

Hip; Cementless total hip arthroplasty; COREN hip system

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip*
Follow-Up Studies*
Hip Prosthesis
Hip
Humans
Korea
Osteolysis
Periprosthetic Fractures
Prospective Studies
Prosthesis Failure

Figure

  • Fig. 1 Photographs showing the COREN hip system with an alumina-on-alumina bearing.

  • Fig. 2 Harris hip scores, WOMAC scores, and UCLA activity scores for the COREN total hip prosthesis.

  • Fig. 3 (A) Preoperative radiograph of a 44-year-old man with osteoarthritis following septic sequelae of the left hip. (B) Postoperative radiograph 4 weeks after index arthroplasty showing a well-positioned prosthesis. (C) A Radiograph at 7 years after surgery showing stable bony fixation of both the acetabular cup and femoral stem.

  • Fig. 4 Seven-year Kaplan-Meier survival curves using (A) any reoperation and (B) any revision for any reason as the end point.

  • Fig. 5 Photographs showing the upgraded COREN hip system. (A) Increased neck offset to prevent soft tissue laxity. (B) A surface treatment with micro-arc oxidation (MAO). (C) A metallic cup with increased hole number and surface porosity and roughness.


Cited by  1 articles

Cementless Total Hip Arthroplasty Using the COREN Hip System: A Minimum Five-Year Follow-up Study
Hee Joong Kim, Jeong Joon Yoo, Wonyeong Seo, Min Nyeon Kim, Taehoon Kang
Hip Pelvis. 2018;30(3):162-167.    doi: 10.5371/hp.2018.30.3.162.


Reference

1. Park YS, Kim YS, Lee JM, Sun DH, Moon YW, Lim SJ. Cementless total hip arthroplasty with use of the coren hip system. J Korean Hip Soc. 2007; 19:457–462.
Article
2. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969; 51:737–755.
Article
3. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15:1833–1840.
4. Beaulé PE, Dorey FJ, Hoke R, Le Duff M, Amstutz HC. The value of patient activity level in the outcome of total hip arthroplasty. J Arthroplasty. 2006; 21:547–552.
Article
5. Johnston RC, Fitzgerald RH Jr, Harris WH, Poss R, Müller ME, Sledge CB. Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results. J Bone Joint Surg Am. 1990; 72:161–168.
Article
6. DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976; (121):20–32.
Article
7. Gruen TA, McNeice GM, Amstutz HC. "Modes of failure" of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res. 1979; (141):17–27.
8. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am. 1982; 64:1295–1306.
Article
9. Martell JM, Pierson RH 3rd, Jacobs JJ, Rosenberg AG, Maley M, Galante JO. Primary total hip reconstruction with a titanium fiber-coated prosthesis inserted without cement. J Bone Joint Surg Am. 1993; 75:554–571.
Article
10. Christie MJ, DeBoer DK, Trick LW, et al. Primary total hip arthroplasty with use of the modular S-ROM prosthesis. Four to seven-year clinical and radiographic results. J Bone Joint Surg Am. 1999; 81:1707–1716.
Article
11. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res. 1990; (257):107–128.
Article
12. Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973; 55:1629–1632.
13. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br. 1987; 69:45–55.
Article
14. Joshi RP, Eftekhar NS, McMahon DJ, Nercessian OA. Osteolysis after Charnley primary low-friction arthroplasty. A comparison of two matched paired groups. J Bone Joint Surg Br. 1998; 80:585–590.
15. Hodgkinson JP, Shelley P, Wroblewski BM. The correlation between the roentgenographic appearance and operative findings at the bone-cement junction of the socket in Charnley low friction arthroplasties. Clin Orthop Relat Res. 1988; (228):105–109.
Article
16. Kubo T, Inoue S, Maeda T, et al. Cementless Lord total hip arthroplasty: cup loosening common after minimum 10-year follow-up of 103 hips. Acta Orthop Scand. 2001; 72:585–590.
Article
17. Murray DW, Britton AR, Bulstrode CJ. Loss to follow-up matters. J Bone Joint Surg Br. 1997; 79:254–257.
Article
18. Han IH, Choi JH, Zhao BH, Baik HK, Lee IS. Micro-arc oxidation in various concentration of KOH and structural change by different cut off potential. Curr Appl Phys. 2007; 7:Suppl 1. e23–e27.
Article
19. Dastane M, Dorr LD, Tarwala R, Wan Z. Hip offset in total hip arthroplasty: quantitative measurement with navigation. Clin Orthop Relat Res. 2011; 469:429–436.
Article
20. Matsushita A, Nakashima Y, Jingushi S, Yamamoto T, Kuraoka A, Iwamoto Y. Effects of the femoral offset and the head size on the safe range of motion in total hip arthroplasty. J Arthroplasty. 2009; 24:646–651.
Article
21. Min BW, Song KS, Bae KC, Cho CH, Kang CH, Kim SY. The effect of stem alignment on results of total hip arthroplasty with a cementless tapered-wedge femoral component. J Arthroplasty. 2008; 23:418–423.
Article
22. Munuera L, Garcia-Cimbrelo E. The femoral component in low-friction arthroplasty after ten years. Clin Orthop Relat Res. 1992; (279):163–175.
Article
23. Schramm M, Keck F, Hohmann D, Pitto RP. Total hip arthroplasty using an uncemented femoral component with taper design: outcome at 10-year follow-up. Arch Orthop Trauma Surg. 2000; 120:407–412.
Article
24. Jaffe WL, Hawkins CA. Normalized and proportionalized cemented femoral stem survivorship at 15 years. J Arthroplasty. 1999; 14:708–713.
Article
25. Vresilovic EJ, Hozack WJ, Rothman RH. Radiographic assessment of cementless femoral components. Correlation with intraoperative mechanical stability. J Arthroplasty. 1994; 9:137–141.
26. Ries MD, Lynch F, Jenkins P, Mick C, Richman J. Varus migration of PCA stems. Orthopedics. 1996; 19:581–585. discussion 585-6.
27. Aldinger PR, Jung AW, Breusch SJ, Ewerbeck V, Parsch D. Survival of the cementless Spotorno stem in the second decade. Clin Orthop Relat Res. 2009; 467:2297–2304.
Article
28. Müller LA, Wenger N, Schramm M, Hohmann D, Forst R, Carl HD. Seventeen-year survival of the cementless CLS Spotorno stem. Arch Orthop Trauma Surg. 2010; 130:269–275.
Article
29. Biemond JE, Pakvis DF, van Hellemondt GG, Buma P. Long-term survivorship analysis of the cementless Spotorno femoral component in patients less than 50 years of age. J Arthroplasty. 2011; 26:386–390.
Article
30. Ström H, Nilsson O, Milbrink J, Mallmin H, Larsson S. Early migration pattern of the uncemented CLS stem in total hip arthroplasties. Clin Orthop Relat Res. 2007; 454:127–132.
Article
31. Rozkydal Z, Janícek P, Tomás T, Florian Z. [Long-term results of the CLS acetabular cup in primary total hip replacement]. Acta Chir Orthop Traumatol Cech. 2009; 76:90–97.
32. Hrubina M, Behounek J, Skoták M. [Mid-term results of cementless ultima cups in primary total hip replacement]. Acta Chir Orthop Traumatol Cech. 2008; 75:205–211.
33. Belmont PJ Jr, Powers CC, Beykirch SE, Hopper RH Jr, Engh CA Jr, Engh CA. Results of the anatomic medullary locking total hip arthroplasty at a minimum of twenty years. A concise follow-up of previous reports. J Bone Joint Surg Am. 2008; 90:1524–1530.
Article
34. Lim YW, Lee KH, Bae SH, Kwon SY. Comparative analysis of two cementless stems in total hip arthroplasties in patients with osteonecrosis of femoral head: summit(R) stem and bencox (R) stem. J Korean Hip Soc. 2012; 24:25–31.
Article
35. Grant P, Nordsletten L. Total hip arthroplasty with the Lord prosthesis. A long-term follow-up study. J Bone Joint Surg Am. 2004; 86-A:2636–2641.
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