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  11. 1000 Collared Cementless Femoral Stems: Periprosthetic Fracture Rates In 500 Tha Versus 500 Hemiarthroplasties

1000 collared cementless femoral stems: periprosthetic fracture rates in 500 THA versus 500 hemiarthroplasties

Brian Rigney1, Evelyn P Murphy2, Meadhbh Ni Mhiochain De Grae2

  • 1University Hospital Galway, Galway, Ireland. brianrigney@rcsi.com.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|June 8, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Collared cementless stems are safe for hip fracture surgery. This study found similar rates of periprosthetic fractures in elective hip replacement and hip fracture patients, showing safety in hemiarthroplasty.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Geriatric Medicine

Background:

  • Investigating the safety of collared cementless femoral stems in elderly patients undergoing total hip arthroplasty (THA).
  • Addressing concerns that these patients are vulnerable to neck of femur (NOF) fractures, potentially necessitating cemented prostheses.
  • Comparing fracture incidence between elective THA and NOF fracture patients.

Purpose of the Study:

  • To compare the incidence of intra-operative and early postoperative periprosthetic fractures (PPF) in elective THA versus NOF fracture patients.
  • To evaluate the safety and efficacy of using a collared cementless femoral stem in both patient groups.
  • To assess 90-day mortality rates associated with each surgical approach.

Main Methods:

  • Single-institution retrospective cohort study (August 2015 - December 2023).
Keywords:
Collared cementless femoral stemsHemiarthroplastyNeck of femur fracturePeriprosthetic fracture

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  • Comparison of 500 consecutive elective THAs and 500 consecutive NOF fractures treated with a collared cementless femoral stem.
  • Primary outcome: intra-operative PPF. Secondary outcomes: early PPF (within 90 days) and 90-day mortality.

    • Main Results:

    • Intra-operative PPF occurred in 1.4% of THA patients versus 3% of NOF fracture patients (p=0.09).
    • Early PPF (within 90 days) was observed in 0.6% of THA patients and 0.8% of NOF fracture patients (p=0.7).
    • 90-day mortality was 0% in the elective THA group and 8.8% in the NOF fracture group.

    Conclusions:

    • Collared cementless femoral stems demonstrate safety in hemiarthroplasty for hip fractures.
    • The findings support the use of cementless stems in hip fracture management, particularly in institutions standardizing this approach.
    • No significant difference in periprosthetic fracture rates was found between elective THA and NOF fracture groups when using this stem type.
    Total hip arthroplasty