ArticleArchives of orthopaedic and trauma surgery2026
Does femoral stem choice associate with survivorship and clinical outcomes after conversion total hip arthroplasty? A retrospective analysis and novel treatment algorithm.
Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConversion total hip arthroplasty (cTHA) after prior proximal femoral fracture fixation can be performed using different femoral stems. This study aimed to (1) determine if initial fracture fixation or pattern associated with stem design in cTHA, (2) evaluate whether stem type was associated with survivorship and outcomes, and (3) propose a radiographic measurement to guide femoral stem selection.
methodsWe retrospectively reviewed 51 patients who underwent cTHA from 2016 to 2020, including 44 patients with previous cephalomedullary nail (CMN; 86.3%) and 9 patients with previous sliding hip screw (SHS; 13.7%). Stems included 32 uncemented diaphyseal-engaging (62.7%), 10 uncemented metaphyseal-engaging (19.6%), and 9 cemented (17.6%). Outcomes assessed were fracture pattern, fixation construct, stem type, survivorship, post-operative complications, and patient-reported outcome measures. Preoperative radiographs were evaluated for diaphyseal width (D), distance from greater trochanter to most distal pre-isthmic screw (GS), and ratio of GS/D (GSD). These measures were used to construct an algorithm for stem selection at the time of cTHA. Mean follow-up was 69 months. Survivorship free from stem-related and all-cause failure was calculated using Kaplan-Meier analysis.
resultsDiaphyseal-engaging uncemented stems were used more often after CMN fixation, while metaphyseal-engaging uncemented stems predominated after SHS fixation. Diaphyseal-engaging stems predominated in previous intertrochanteric, subtrochanteric, or complex fractures, while metaphyseal-engaging uncemented stems were more common in femoral neck fractures. Survivorship free from stem-related failure was 100% and from all-cause reoperation was 89%. Patients who received cemented stems were older, more likely to require transfusion or prolonged use of an assistive walking device. No significant differences were observed in complications, clinical outcomes or PROMs between stem groups. Higher GSD ratios correlated with diaphyseal-engaging stem use in SHS and long-CMN cases.
conclusionFemoral stem fixation type in cTHA correlated with prior fracture pattern and fixation construct. Survivorship free from stem-related failure requiring stem revision was 100% and survivorship free from all-cause failure was 89%. We propose a novel algorithm that may assist surgeons in selecting femoral stem at the time of cTHA using different patient-specific and radiographic factors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.