Large cementless stems may increase risk of THA revision for periprosthetic fracture
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Key takeaways:
- Large cementless hip stems had higher rates of revision surgery for periprosthetic fracture compared with small to medium stems.
- Collared stems had lower rates of revision due to periprosthetic fracture.
Compared with small to medium stems, large cementless hip stems had a higher rate of revision due to periprosthetic fractures, according to results published in the Journal of Arthroplasty.
Using the Australian Orthopaedic Association National Joint Replacement Registry, researchers analyzed data from 59,518 primary total hip arthroplasty procedures performed between September 1999 and December 2021 with a single cementless hip stem and modern bearings.
Researchers compared rates of revision due to periprosthetic fracture between procedures with small to medium stems (size 6 to 13, n = 51,760) and large stems (size 14 to 20, n = 7,758), According to the study, they also performed a sub-analysis of procedures with collared stems.
Overall, the cumulative percent revision for periprosthetic fracture at 17 years was 3.1% for small to medium stems and 3.9% for large stems. Sub-analysis revealed 61 collared stems and 251 collarless stems were revised due to periprosthetic fracture.
“Surgeons should be mindful of this finding, particularly in patients who have increased fracture risk,” the researchers wrote in the study. “Collared cementless hip stems have a lower rate of revision for periprosthetic fracture than collarless stems and may be a better option in high-risk patients, particularly in those requiring large stems,” they added.
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