EMEA Surgeons Weigh in on the Choice of Using Collared Stems in THA

collared stems in THA - why the push toward collared stems?

Join in on the Discussion at EFORT on the Advantages of Using a  Collar with our Hip Team in Booth B2.9 at EFORT 2023   

At DePuy Synthes, we're on a mission to revolutionise hip replacement and reconstruction. By creating class-leading implants, technique-inclusive offerings and innovative technologies, we enable surgeons to develop customised solutions for every patient. Our mission is to Keep People Moving, and we want to ensure that the hundreds of thousands of patients who need hip replacements each year get the movement they deserve. 

For over 20 years, CORAIL™ and PINNACLE™ have worked together to provide patients with exceptional outcomes and surgeons with an easy-to-use implant system they can tailor to fit their patient’s needs. On our continuum of hip replacement solutions, our cementless CORAIL™ Total Hip System is available both with and without a collar. 

Why the push towards collared stems? 

Interested in the range of decision factors that surgeons across Europe consider in their collarless vs. collared decision-making process, we decided to ask for their views. In the videos below, you’ll hear their impressions on using the collar, how they approached the decision, and the role that registry data played in the process.  

But first, the evidence itself 

Both the collarless and collared versions of the CORAIL Stem have demonstrated excellent long-term survival in historic cohort studies and national registries,1 with similar patient-reported outcomes and radiographic results in prospective and retrospective comparative studies. 

Our Collared CORAIL Stem with PINNACLE™ Cup has shown:   

  • 29% reduced risk of revision (HR 0.71 (0.67, 0.75) p<0.0011    
  • A statistically significant adjusted health gain at six months, as measured by the Oxford Hip Score, EQ-5D and EQ-VAS (all p<0.001).1
  • Statistically fewer than expected revisions due to pain, dislocation and peri-prosthetic fracture (all p<0.001)1 when compared to all other cementless hips on the NJR.    

Does a preference for collared mean that collarless is performing badly?   

Life, like hip arthroplasty, is full of choices. A careful weighing of study data, personal experience, and the experience and opinions of thought leaders can pave the way towards making the right decision for a particular case or philosophical direction of a practice when it comes to choice of implant, technique or specific design element. In this research summary, Jean-Pierre Vidalain, MD, Executive Secretary of the Artro Group Institute, offers an informed answer to the question, “Does the drive towards increased use of the collared CORAIL™ Stem mean the collarless stem is performing badly?”

How does the collar work?    

If a picture speaks a thousand words, a video speaks even more. Watch now as Professor Tim Board of the Wrightington Hospital in England explains in detail how the collar on the CORAIL Stem works.    


Why are some surgeons changing their practices?    

Conversations with hip surgeons shed insight on why some of them are changing their practices in favor of the collar. The following video provides one surgeon-suggested framework on how to approach the decision. Watch as Dr. Helge Wangen from the Orthopaedic Department of the Sykehuset Innlandet Hospital Trust in Norway discusses how he decided to move to the collared CORAIL stem, although he had been satisfied with his collarless results to date.      


Are you considering changing your view on the collar - why or why not?

Surgical philosophies evolve over time, shaped by a body of learnings, experiences and discussions. In this video, Professor Michael M. Morlock from the Institute of Biomechanics at the TUHH Hamburg University of Technology in Germany explains why he changed his view on the collar.    


What role can NJR data play in a surgeon’s decision?    

Dr Emilio Romanini of the RomaPro Center for Hip and Knee Arthroplasty has been qualified as a hip and knee surgeon for over 20 years and completes approximately 300 primary hip replacements per year. In this video, he answers the question: “Can I trust registry data?” Dr Romanini confirms that he reads the annual reports from UK, Australia and the Scandinavian countries, and that he believes that it “should be mandatory for every surgeon performing joint replacements.”2  

According to Dr. Romanini, “The fact that CORAIL is widely used in countries with a registry offers an incredible amount of data to rely on, that are made available both through annual reports and published insight analysis from the original data on orthopaedic journals. This is a precious piece of information that allows for [the evaluation of] a number of variables related to the device, to the patient and to the surgeon.” 2 In this video, he also outlines the other parts of his decision-making process and concludes that his “choice is a collared stem.” 2

Is it really the collar that drives the difference?    

In this video, Placido Zamora-Navas of the Orthopaedics Surgery and Traumatology department of the Universidad de Málaga in Spain also answers the question about whether or not he trusts registry data. He also shares his views on whether or not the collar is driving the difference.


Continuing the discussion 

Whether in person at a Hip congress or other venue, or via digital means, we look forward to continuing the discussion around collarless vs. collared with you, and hope to hear which data or opinions expressed by the hip experts featured in these videos have influenced your own decisions. 

To learn more about CORAIL and PINNACLE, please visit our resources page: https://www.jnjmedtech.com/en-EMEA/hip/resources 

To learn more about the broad range of solutions in our Hip Specialties area, visit this link: https://jnjinstitute.com/en-emea/online-profed-resources/resources/joint-arthroplasty/hip   

About DePuy Synthes 

DePuy Synthes, The Orthopaedics Company of Johnson & Johnson, provides one of the most comprehensive orthopaedics portfolios in the world that helps heal and restore movement for the millions of patients we serve. DePuy Synthes solutions, in specialties including joint reconstruction, trauma, extremities, craniomaxillofacial, spinal surgery and sports medicine, in addition to the VELYS™ Digital Surgery portfolio, are designed to advance patient care while delivering clinical and economic value to healthcare systems worldwide. Building on our proud product innovation and legacy of industry firsts, we are reimagining the orthopaedic landscape with new advancements in medical technologies and digital surgery across the entire continuum of care to Keep People Moving today and tomorrow. For more information, visit www.depuysynthes.com.     

© DePuy Synthes 2023. All rights reserved.    

Please refer to the instructions for use for a complete list of indications, contraindications, warnings and precautions. Not for distribution outside of the EMEA region. Third party trademarks used herein are the trademarks of their respective owners. The views and opinions expressed in these videos and quotes are those of the presenters and do not necessarily represent the views of DePuy Synthes.         


  1. DePuy Synthes. Bespoke Report. CORAIL Collared Stem with PINNACLE Cup vs. Cementless Hips. NJR. Produced 15/06/21. Report can be accessed at https://www.jnjmedtech.com/en-EMEA/corail-pinnacle/resources/njr-bespoke-reports.  
  2. DePuy Synthes. Interview transcript with Dr Emilio Romanini. 211313-220427 EMEA. May 2022.     

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