SynthesisArchives of orthopaedic and trauma surgery2024
Risk factors for femoral stem fracture following total hip arthroplasty: a systematic review and meta analysis.
Synthesis in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Wear performance of metal and ceramic long-neck femoral head taper connections: an experimental ex vivo study.Acta orthopaedica · 2026Article
- Toward next-generation hip implants: From failure mechanisms to translational design.Journal of orthopaedic translation · 2026Review
- A Novel Approach to Atypical Periprosthetic Femoral Fractures with Stem Breakage: A Case Report.Journal of orthopaedic case reports · 2025Article
- Short-Term Complications of Revision Total Hip Arthroplasty of the Acetabular, Femoral, or Both Components: A National Surgical Quality Improvement Program Database Study.Arthroplasty today · 2025Article
- Evaluating the risk factors for Lubinus SP II femoral stem fractures: A case series of 5 primary total hip arthroplasty patients with a mean follow-up of 7.5 years.SAGE open medical case reports · 2025Article
- Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFemoral stem fracture following total hip arthroplasty (THA) is an infrequent but nevertheless devastating complication, with an increasing worldwide prevalence as demand for primary THA continues to increase. The aim of this study was to perform a systematic review and meta-analysis of risk factors for femoral stem fracture to help identify at risk patients.
methodsA systematic search was conducted on EMBASE, MEDLINE and AMED to identify relevant studies. Data regarding study design, source, population, intervention, and outcomes was collated. Data extraction was performed on a custom form generated using Cochrane recommended methodology and analysis of risk factors performed including odds ratios (ORs) with 95% confidence intervals (CIs).
resultsA total of 15 studies reporting a total of 402 stem fractures in 49 723 THAs were identified. The median time from index procedure to stem fracture was 68 months (IQR 42.5-118) whilst mean age at index surgery was 61.8 years (SD 6.9). Male gender (OR = 3.27, 95% CI = 2.59-4.13, p < 0.001), patient weight above 80 kg (OR = 3.55, 95% CI = 2.88-4.37, p < 0.001), age under 63 years (OR = 1.22, 95% CI = 1.01-1.49, p < 0.001), varus stem alignment (OR = 5.77, 95% CI = 3.83-8.7, p < 0.001), use of modular implants (OR = 1.95, 95% CI = 1.56-2.44, p < 0.01) and undergoing revision arthroplasty (OR = 3.33, 95% CI = 2.70-4.1, p < 0.001) were significant risk factors for prosthetic stem fracture. A risk window of 15 years post-surgery was identified.
conclusionsThis review concludes that patient weight, younger age, male sex, varus stem alignment, revision arthroplasty and use of modular stems are significant risk factors for femoral stem fracture. Modifying these risk factors where possible may help reduce incidence of femoral stem fracture in at risk patients.
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