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Updated: Oct 8, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Femoral Stem Subsidence in Total Hip Arthroplasty: Comparison between Fixation Principles
André N B M de Macedo1, Lourenço P Peixoto1, João A M Guimarães1
1Divisão de Ensino e Pesquisa, Instituto Nacional de Traumatologia e Ortopedia, Rio de Janeiro, RJ, Brazil.
Objective:
To compare the magnitude of subsidence between single- (SW) and double-wedge (DW) femoral stems in primary total hip arthroplasties (THAs), and to identify factors associated with clinically relevant subsidence.
Methods:
Retrospective cohort study with 82 patients (164 hips) undergoing bilateral THA between 2012 and 2022, each receiving type-I (Corail) and -II (Summit) stems, both manufactured by DePuy Synthes. Subsidence was measured radiographically up to 6 months postoperatively and was considered clinically relevant when greater than 3 mm. Radiographic variables included cortical enlargement index (CEI) and canal fill rate (CFR). Statistical analyses included paired t-test, logistic regression, and Spearman correlation.
Results:
The mean subsidence was 1.93 ± 1.16 mm in type-I stems and 2.23 ± 1.57 mm in type-II ( p = 0.181). Clinically relevant subsidence occurred in 18.2% of type-I stems and 31.7% of type-II (OR = 2.07; p = 0.050). Greater subsidence was observed in the first surgery in bilateral arthroplasties ( p = 0.006). There was no significant correlation between subsidence, age, body mass index (BMI), CEI, or CFR.
Conclusion:
The DW stems were associated with a higher risk of clinically relevant subsidence. In bilateral THA, subsidence is more pronounced at first surgery, with no detectable influence of demographic or radiographic factors.
