ArticleArchives of orthopaedic and trauma surgery2023
Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem.
Article in Archives of orthopaedic and trauma surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Optimal Bone Preparation for Triple-Tapered Stems: Does the Sagittal Taper Affect Optimal Femoral Sizing?Arthroplasty today · 2025Article
- Tri-Lock Bone Preservation Stem Versus Conventional Corail Stem in Primary Total Hip Arthroplasty via Direct Anterior Approach: A Short-Term, Retrospective, Comparative Study.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionFully hydroxyapatite-coated titanium alloy double-tapered stems have been successful implant designs for THA. The Novation Element Stem (Exactech, Gainesville, FL) is one of several of these implants following a modified Corail design philosophy. Although a great deal is known about the results of the Corail stem, little is known about the more recent Corail-inspired implants. The authors evaluated the clinical outcomes, radiographic findings and survival statistics of the collarless version of the Element Stem when used routinely in a diverse patient population.
methodsA retrospective review was performed for all primary THR cases from 2010 to 2018. Patient demographics and HHS/OHS/patient satisfaction scores were obtained. Radiographs were evaluated for stem subsidence, radiolucencies, and bone responses to the implant.
resultsOne hundred and fifty seven Element Stems were implanted with greater than 2 years of radiographic follow-up, while 105 Element Stems implanted during the study period had a survival of 5 years or more. Average HHS was 91.7 and average OHS was 44.0. 54 of 157 hips had radiolucencies, all of which included a proximal zonal radiolucency. Average subsidence was 3.33 mm; 18 hips had subsidence > 4 mm. There were 8 revisions for: aseptic loosening (4), trauma-related peri-prosthetic fractures, and early proximal-medial fractures. At 5 years, the all-cause survival rate is 92.4%, 96.2% based only on aseptic loosening and 98.1% based only on proximal medial fractures.
conclusionClinical outcomes using the collarless Novation Element Stem are good, but early proximal medial fracture is still a factor in patients with poor-quality bone. Proximal radiolucencies progressing to aseptic loosening post-operatively are also a concern. The 11.5% rate of subsidence is comparable to other fully HA-coated collarless stems. This study provides a thorough critical analysis of outcomes and midterm survival data of this dual tapered-wedge fully HA-coated collarless stem used routinely in a diverse patient population.
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