Early Outcomes Following Total Hip Arthroplasty With a Newly Designed, Collared Triple-Tapered Cementless Femoral Stem

Abstract

Background: Cementless femoral fixation in total hip arthroplasty (THA) is the most frequently utilized technique in the United States due to the efficacy of biologic fixation and reduced intraoperative times compared with cemented fixation, but has been associated with complications, including periprosthetic fracture and loosening. A recently introduced collared triple-tapered cementless stem has been engineered to address and mitigate these adverse events, but its safety remains unproven. The purpose of this study was to report early complications and causes of failure of this stem and to report patient satisfaction and function.

Methods: A retrospective review of patients who underwent primary THA using this device at a single institution from April 2022 to January 2024 was conducted. A total of 443 cases were performed that met the inclusion criteria. Patient demographics, including age, sex, American Society of Anesthesiologists score, and comorbidities, were collected. The primary outcome of interest was early complications (within 90 days) requiring readmission or revision surgical intervention. Patient-reported outcome measures (PROMs) such as the Veterans Rand 12 Item Health Survey (both physical and mental components), Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement, and the Harris Hip Score were also recorded and analyzed.

Results: A total of six patients (1.4%) required reoperation or readmission following their THA. There was one Vancouver B2 periprosthetic fracture sustained after a fall at physical therapy (0.2%) and one acute periprosthetic infection (0.2%) that required reoperation. There were four patients who had medical issues requiring readmission (0.9%). There were no cases of dislocation or early loosening. Patients experienced significant improvements in their patient-reported outcome measures at both the 6-week mark and at the final postoperative follow-up visit (P < 0.0001).

Conclusions: The recently introduced femoral stem appears to be a safe and effective implant option in the short-term postoperative period, resulting in low complication rates and high levels of patient satisfaction. Future longer-term follow-up studies are necessary to fully characterize its risk profile and effectiveness.

Keywords: cementless; complications; femoral stem; total hip arthroplasty; triple-taper.