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. 2024 Oct 6;13(19):5943.
doi: 10.3390/jcm13195943.

Single-Taper Conical Tapered Stem in Total Hip Arthroplasty for Primary Osteoarthritis: A Comparative Long-Term Registry Evaluation

Francesco Castagnini  1 , Barbara Bordini  2 , Monica Cosentino  2 , Mara Gorgone  1 , Andrea Minerba  1 , Marco Rotini  1 , Emanuele Diquattro  1 , Francesco Traina  1   3
Affiliations

Single-Taper Conical Tapered Stem in Total Hip Arthroplasty for Primary Osteoarthritis: A Comparative Long-Term Registry Evaluation

Francesco Castagnini et al. J Clin Med. .

Abstract

Background/Objectives: Single-taper conical tapered stems (STCTSs) are possible options for femoral reconstruction in THA performed for primary osteoarthritis, but outcomes are poorly ascertained. A specific STCTS in THA performed for primary osteoarthritis was investigated and compared to a control group including all the other cementless stems, aiming to assess the following: (1) the survival rates of the two cohorts and the hazard ratios for failure; (2) the survival rates and the hazard ratios for failures for stem failure, stem aseptic loosening, and periprosthetic fracture. Methods: A regional arthroplasty registry study evaluating a specific STCTS in THA performed for primary osteoarthritis was designed. A control group including all the other cementless stems was considered. Results: In total, 1773 STCTSs were compared to 37,944 cementless stems. The cumulative survivorship of the STCTS cohort was 95.6% at 10 years and 92.7% at 15 years, which was not different to the control group (p = 0.252). After age stratification, the hazard ratio for STCTS failure was not different to the control group. With stem revision as the endpoint, the STCTS cohort outperformed the control group (at 10 years, 98% versus 96.8%; p < 0.001). The STCTSs achieved better survival rates in females <65 years (p = 0.023). With stem aseptic loosening as the endpoint, the survival rates did not differ between the two cohorts (p = 0.085), as well as the adjusted hazard ratios (p = 0.264). With periprosthetic fracture as the endpoint, the survival rates were better for the STCTSs (p < 0.001). Conclusions: STCTSs in THA for primary osteoarthritis provided dependable long-term outcomes, not inferior to all the other cementless stems with various designs.

Keywords: Wagner cone; antetorsion; anteversion; aseptic loosening; conical; osteoarthritis; tapered.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The post-operative radiograph of a Wagner Cone stem (B) implanted in a 52-year-old female with primary hip osteoarthritis (A).
Figure 2
Figure 2
The survival rates of the index stem cohort (in red) and the control groups (in blue) were similar in the long term (p = 0.252).
Figure 3
Figure 3
When the population was stratified for age and sex, the two cohorts showed similar survival rates for STCTS (in red) and the control group (in blue). (A) Females aged less than 65; (B) females aged 65 or older; (C) males aged less than 65; (D) males aged 65 or older.
Figure 4
Figure 4
The distribution of the failures according to the time of onset; STCTS in green and control group in red.
See this image and copyright information in PMC

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