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Updated: May 25, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Cemented Femoral Stem Design Is Not Associated With Differences in All-Cause Revision or Specific Failure Modes After
Charles A Gusho1, Wayne Hoskins1, Connor Riley2
1Department of Orthopaedics, University of Missouri, Columbia, Missouri.
Background:
Cemented stem fixation in total hip arthroplasty (THA) for femoral neck fracture (FNF) has increased in utilization. Cemented stems reduce the periprosthetic fracture risk compared to cementless fixation, but it is unclear whether revision varies by stem design in this cohort. We compared taper-slip versus composite beam cemented stems among FNF patients undergoing THA using a modern classification system.
Methods:
Patients ≥ 65 years of age undergoing primary THA for FNF between 2012 and 2021 with a minimum 2-year follow-up were screened within the American Joint Replacement Registry. A total of 3,479 cases (mean [standard deviation] with follow-ups of 78.8 months (28.3)) met inclusion. The primary analysis compared all-cause and 90-day revision between taper slip (n = 599; 17.2%) and composite beam (n = 2,880; 82.8%) stems. The secondary analyses compared revision for aseptic loosening, fracture, infection, dislocation, and mortality. Cox proportional regressions with competing risks of death evaluated the association of revision with stem design when adjusted for confounders.
Results:
Taper-slip stems had an all-cause revision rate of 1.8% (n = 11 of 599) versus composite beams (3.2%; n = 92 of 2,880; P = 0.07). There were no statistically significant differences observed in all-cause revision (hazard ratio [HR] 1.81; 95% confidence interval (CI) 0.96 to 3.40; P = 0.06), 90-day all-cause revision (HR 3.48; 95% CI, 0.82 to 14.67; P = 0.09), revision for fracture (HR, 0.90; 95% CI, 0.29 to 2.73; P = 0.86), aseptic loosening (HR, 1.77; 95% CI, 0.39 to 8.04; P = 0.46), infection (HR 1.40; 95% CI 0.41 to 4.79; P = 0.59), or dislocation (HR, 5.58; 95% CI, 0.76 to 41.0; P = 0.09) compared to composite beam stems after adjustment.
Conclusions:
There were no statistically significant differences in revision observed between taper-slip and composite beam-cemented femoral stems for patients undergoing THA for FNF. Clinically relevant trends (e.g., in early revision and dislocation) warrant further study with larger cohorts and longer follow-up.
