Slightly reduced early subsidence with similar outcomes and complications rate in collared stems - A systematic...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• A rising trend exists in utilizing femoral stems with a medial calcar collar for total hip arthroplasty (THA).
• This approach aims to potentially enhance hip joint stability and implant fixation.

Purpose of the Study:

• To systematically review and compare the efficacy of femoral collared stems versus collarless stems.
• Key outcome measures include early subsidence, patient-reported outcomes (PROs), and revision rates in THA.

Main Methods:

• A comprehensive literature search was conducted on Pubmed and Medline, adhering to PRISMA guidelines.
• Included were randomized controlled trials comparing collared and collarless stems in adult THA patients, focusing on subsidence and PROs.

Main Results:

• Five studies involving 674 patients (704 hips) met the inclusion criteria.
• Collared stems showed statistically significant reduction in early postoperative subsidence compared to collarless stems (p=0.023, p=0.05).
• All studies reported improved PROs, with no significant difference between collared and collarless stems; revision rates were not statistically significant.

Conclusions:

• Femoral collared stems may offer a benefit by reducing early postoperative subsidence.
• No substantial differences were observed in aseptic loosening, thigh pain, or revision rates between collared and collarless stems.
• Both stem types yield similar improvements in patient-reported outcomes from pre- to post-operation.