Outcomes of cemented taper slip versus composite beam femoral stems in total hip arthroplasty: A systematic review and meta-analysis.

Abstract

Objective: The aim of this systematic review and meta-analysis was to compare the outcomes of cemented collared composite beam (CB) and collarless taper slip (TS) femoral stems in total hip arthroplasty (THA).

Methods: Four databases were searched from inception to August 2023 for original studies that compared the outcomes of cemented CB and TS femoral stems following THA. The primary outcome was aseptic loosening, and the secondary outcomes were periprosthetic fractures, instability, dislocation, revision, survivorship, and periprosthetic joint infection (PJI). This review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

Results: A total of 11 studies with 730,769 hips were included, with a mean follow-up period of 8.48 ± 6.07 years and average MINORS (Methodological Index for Non-Randomized Studies) score of 17.36 ± 1.86. There was a statistically significant difference in aseptic loosening (OR 0.28, 95% CI 0.19-0.43, p < 0.001) and PJI rate (OR 0.61, 95% CI 0.53-0.71, p < 0.001) between the CB and TS groups in favor of the latter. However, periprosthetic fracture, revision rate, survivorship, instability, and dislocation were similar in both groups (p  =  NS).

Conclusion: This study showed a significantly higher aseptic loosening and PJI in the CB group compared to the TS stem type. However, other outcomes were comparable. Due to confounding effects, these results must be interpreted in context.