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Updated: Apr 21, 2026
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
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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
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.
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.
