Cementless hydroxyapatite-coated stem with dual mobility and posterior approach in over-80 year-old patients with osteoarthritis: Rates of dislocation and periprosthetic fracture at a mean 8 years' follow-up

BACKGROUND: Straight cementless stems are common in primary total hip arthroplasty (THA) in the elderly, but controversial due to higher risk of loosening and periprosthetic fracture (PPF). Apart from registries, results for the Corail implant and dual mobility (DM) in over-80 years-old are not known, notably in case of systematic association to a DM cup. We therefore performed a retrospective analysis of Corail implants in patients aged?80years at implantation for osteoarthritis of the hip, assessing 1) PPF rate and survival for cementless straight stems associated to DM cups, 2) complications, and dislocation in particular, and 3) clinical scores.HYPOTHESIS: PPF and dislocation rates are low in THA with cementless straight stem associated to DM cup in patients aged?80years.PATIENTS METHODS: A retrospective study was conducted in our department for the period July 2007 to December 2012. Inclusion criteria were age?80years, with primary THA for osteoarthritis. Exclusion criteria were revision procedure and femoral neck fracture. One hundred and twenty-eight consecutive THAs were included, in 120 patients, with a minimum 5years' follow-up. Clinical results were assessed on Harris Hip Score (HHS) and Oxford Hip Score (OHS). Data were collected for PPF or dislocation and other complications.RESULTS: At a mean 8±1 years' follow-up (range, 5-10 years), 66 patients (55%, for 68 hips) were alive, 48 (40%, for 54 hips) had died, and 6 (5%, for 6 hips) were lost to follow-up. Median age at surgery was 83years (range, 80-93years). Mean OHS at last follow-up was 41±6 (range, 21-48) and HHS 83±14 (range, 23-100) with mean gain of 32 points (95% CI, [28-36]; p