ReviewMusculoskeletal surgery2026
Is the use of primary cementless stem in revision total hip arthroplasty a reliable option? A systematic review.
Review in Musculoskeletal 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.
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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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Authors and funding
6 authors.
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Abstract
backgroundWhile revision-specific stems are standard for revision total hip arthroplasty (rTHA), cementless primary stems are an emerging alternative for patients with preserved bone stock. However, their long-term reliability remains under debate. PURPOSE: To systematically evaluate the safety, fixation durability, and functional outcomes of cementless primary femoral stems in rTHA.
methodsFollowing PRISMA guidelines (PROSPERO: CRD420251232433), we searched MEDLINE, Embase, Cochrane, and Web of Science through November 2025. Risk of bias was assessed using RoB-2 and ROBINS-I. Pooled event rates were calculated using a random-effects model.
resultsTwenty-one studies involving 2,109 rTHAs were analyzed over a mean follow-up of 97.6 months, primarily involving Paprosky type I and II defects. The pooled aseptic loosening rate was 2.96% (95% CI 2.28-3.73), while the overall complication rate was 14.34% (95% CI 12.87-15.86). Reoperations occurred in 9.65% of cases (95% CI 8.42-10.94), frequently due to aseptic loosening. Functional outcomes were favorable, evidenced by a mean Harris Hip Score of 81.03 at final follow-up.
conclusionCementless primary femoral stems are a reliable option for rTHA in patients with preserved metaphyseal bone, demonstrating low aseptic loosening rates and favorable functional outcomes at mid- to long-term follow-up. While these results support their use, further high-quality comparative research is necessary to define specific indications against revision-specific implants.
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