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Related Experiment Video

Updated: Apr 21, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Collared Triple Taper Stems Have Superior Biomechanical Characteristics in Compromised Bone.

Sean Rajaee1, Dave T Huang1,2, Andrew Nakla1

  • 1Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, CA, USA.

Arthroplasty Today
|April 20, 2026
PubMed
Summary

Collared triple-taper stems offer superior biomechanical stability in osteoporotic femurs compared to other uncemented designs. This finding supports their use in hip arthroplasty for patients with compromised bone quality.

Keywords:
Femoral stem designPeriprosthetic fractureSubsidenceTotal hip arthroplastyTriple taper

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Materials Science

Background:

  • Femoral periprosthetic fractures are a significant cause of revision total hip arthroplasty, particularly in osteoporotic patients.
  • Uncemented press-fit stems are widely used despite the protective benefits of cemented stems.
  • Biomechanical evaluation of stem designs is crucial for improving implant longevity and reducing revision rates.

Purpose of the Study:

  • To biomechanically compare the resistance to subsidence and failure of different uncemented femoral stem designs in a synthetic osteoporotic femur model.
  • To quantify the performance of collared versus collarless triple-taper stems.
  • To assess the impact of stem design on rotational stiffness and torque to failure.

Main Methods:

  • Twenty-four synthetic osteoporotic femurs were implanted with four types of uncemented stems: single-wedge, triple-taper with collar, triple-taper without collar, and fit-and-fill.
  • Femurs underwent 10,000 cycles of axial and torsional loading to simulate walking.
  • Measurements included stem subsidence, rotational stiffness, and torque to failure.

Main Results:

  • The triple-taper stem with a collar exhibited the least subsidence (0.53 ± 0.12 mm), significantly less than the single-wedge stem (1.4 ± 0.2 mm).
  • The collared triple-taper stem demonstrated significantly greater rotational stiffness compared to all other designs.
  • Both triple-taper stem designs showed significantly higher torque to failure than single-wedge and fit-and-fill stems.

Conclusions:

  • Collared triple-taper femoral stems possess superior biomechanical properties, including reduced subsidence and enhanced torsional stability.
  • These findings suggest that collared stems are a favorable option for uncemented total hip arthroplasty in patients with compromised bone.
  • Further clinical investigation is warranted to confirm the long-term benefits of collared triple-taper stems in this patient population.