ArticleJournal of orthopaedics
The influence of femoral component design on postoperative periprosthetic femoral fracture after uncemented direct anterior total hip arthroplasty in the elderly.
Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 9 citations in OpenAlex.
- Collared Triple Taper Stems Have Superior Biomechanical Characteristics in Compromised Bone.Arthroplasty today · 2026Article
- Two-Dimensional Preoperative Digital Templating is Less Accurate When Using a Collared Triple Taper Stem Versus a Single Taper Design.Arthroplasty today · 2025Article
- Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis.EFORT open reviews · 2024Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAging populations and expanding indications will greatly increase the volume of total hip arthroplasty (THA) in all age groups, including patients over 70 years old. Minimally invasive, uncemented direct anterior THA offers potential advantages for treating elderly patients. However, literature indicates higher risks of postoperative periprosthetic femur fractures (PPFFs) with both direct anterior THA and uncemented femoral stems. This retrospective study investigates the influence of femoral stem design on PPFF incidence in uncemented direct anterior THA among patients older than 70 years.
methods557 primary THAs in patients aged 70 or over were reviewed for PPFFs from a consecutive series of 2011 patients undergoing direct anterior THA from a fellowship-trained adult reconstruction surgeon from 2015 to 2020. Exclusion criteria included age (<70) and posterior approach. For the first cohort of 361 patients (79 of which passed exclusion criteria) the surgeon used a single-tapered, proximally porous coated, collarless titanium stem. For the next 1650, (478 of which passed exclusion), the surgeon used a dual-tapered, collared, hydroxyapatite-coated titanium stem. Included patients were carefully monitored until March 2021 for PPFFs. A Fisher's exact test was used to compare the incidence PPFFs between the 2 implant designs.
results2 of 79 (2.5%) patients had atraumatic PPFFs at an average of 19.5 days post-operatively in the first cohort. Both experienced a Vancouver type B2 periprosthetic fracture and required femoral revision. No patients (0/478, 0%) in the second group sustained a PPFF. (P = 0.0199).
conclusionIn this comparison, the dual-taper, hydroxyapatite-coated implant had a significantly lower PPFF rate among elderly patients than a single-taper, proximally porous stem without a collar.
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