ArticleOrthopaedic surgery2025
Risk Factors of Aseptic Loosening After Total Hip Arthroplasty With Collum Femoris Preserving Stem: A Long-Term Follow-Up Study.
Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robot-assisted total knee arthroplasty and the risk of postoperative infection: a systematic review and meta-analysis.Journal of robotic surgery · 2026Pooled it
- Review of the influence of anaemia on the effect of total hip arthroplasty, and the prognosis of patients: recent advances and future directions.Annals of medicine · 2026Review
- Long-Term Outcomes of Triple Cannulated Compression Screws Combined With Bone Graft Sleeve Parallel Implantation of DBM Crunch Internal Fixation for the Treatment of Femoral Neck Fractures in Middle-Aged and Young Adults.Orthopaedic surgery · 2025Article
- Risk Factors of Aseptic Loosening After Total Hip Arthroplasty With Collum Femoris Preserving Stem: A Long-Term Follow-Up Study.Orthopaedic surgery · 2025Article
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6 authors.
Funding
Abstract
objectiveThe Collum Femoris Preserving (CFP) stem offers biomechanical advantages in total hip arthroplasty (THA). However, aseptic loosening remains the most common cause of failure and other severe complications, with specific risk factors associated with the CFP stem remaining inadequately defined. This study aims to investigate the possible factors associated with aseptic loosening.
methodsThis study retrospectively analyzed patients who underwent primary THA with the CFP stem from January 2004 to December 2009 in our institution. Patients were divided into two groups based on whether there was aseptic loosening. Demographic and imaging parameters were collected from medical records and the hospital's Picture Archiving and Communication System (PACS). Comparative analyses were conducted, and variables with significant differences were subjected to Cox regression to identify independent risk factors of aseptic loosening.
resultsA total of 469 hips were included, with 52 hips (11.1%) of aseptic loosening identified. Seven independent risk (protective) factors were found, including ceramic-on-polyethylene (COP) bearing surfaces (Hazard Ratio = 2.084, 95% Confidence Interval: 1.043-4.166, p = 0.038), history of steroid therapy (HR = 2.393, 95% CI: 1.056-5.425, p = 0.037), neck resorption ratio (NRR) (HR = 1.019, 95% CI: 1.005-1.033, p = 0.008), bone mineral density (BMD) (HR = 0.933, 95% CI: 0.891-0.976, p = 0.003), canal fill ratio (CFR) (HR = 0.951, 95% CI: 0.923-0.980, p = 0.001), cortical index (HR = 0.933, 95% CI: 0.891-0.976, p = 0.003), and varus/valgus angle between 3° and 6° (HR = 4.427, 95% CI: 2.303-8.509, p < 0.001), varus/valgus angles > 6° (HR = 8.854, 95% CI: 3.704-21.165, p < 0.001).
conclusionThis study identifies key risk factors contributing to aseptic loosening, including COP bearing surfaces, steroid therapy history, excessive femoral neck resorption, and significant varus/valgus malalignment. Conversely, higher BMD, improved cortical index, and favorable CFR were protective against loosening. These findings underscore the need for careful preoperative assessment and precise intraoperative positioning to optimize long-term implant stability.
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