Arthroplasty Today最新文献

{"title":"Fourth-generation Ceramic Head Fracture in Total Hip Arthroplasty: A Case Report and Literature Review","authors":"Clark Yin MD ,&nbsp;Lauren Eberhardt MD ,&nbsp;Matthew Cederman BS ,&nbsp;Henry Haley MD ,&nbsp;Andrew Steffenmeier MD ,&nbsp;Mark Karadsheh MD","doi":"10.1016/j.artd.2025.101614","DOIUrl":"10.1016/j.artd.2025.101614","url":null,"abstract":"<div><div>Ceramics are used in total hip arthroplasty due to inherent wettability and low wear rates, but fracture risk is a known complication. Rates as high as 13.4% were reported in the past, yet as low as 0.02% in newer generations. Howard et al. reported a fracture rate of 0.009% for fourth-generation ceramic heads. We present a case report of a 69-year-old male with a BMI of 40.01 kg/m² who suffered a fracture of a 36-mm ceramic femoral head with pseudoacetabular involvement of the polyethylene liner. This occurred 2 years and 3 months after his primary surgery after a 4-foot fall off of a ladder. The patient underwent revision of his total hip arthroplasty with arthroplasty of the polyethylene liner and femoral head component without stem explantation.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101614"},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes?","authors":"Justin Leal BS,&nbsp;Christine J. Wu MD,&nbsp;Niall H. Cochrane MD,&nbsp;Thorsten M. Seyler MD, PhD,&nbsp;William A. Jiranek MD,&nbsp;Samuel S. Wellman MD,&nbsp;Michael P. Bolognesi MD,&nbsp;Sean P. Ryan MD","doi":"10.1016/j.artd.2025.101631","DOIUrl":"10.1016/j.artd.2025.101631","url":null,"abstract":"<div><h3>Background</h3><div>This study compared outcomes between patients undergoing outpatient total joint arthroplasty (TJA) at an ambulatory surgery center (ASC) versus a cohort of medically and socially complex patients undergoing TJA at a tertiary healthcare system.</div></div><div><h3>Methods</h3><div>An institutional database at a single academic center was retrospectively reviewed for patients who underwent primary TJA since the opening of an ASC from August 2021 to January 2024. A total of 716 (outpatient: 374; inpatient: 342) total knee arthroplasties and 458 (outpatient: 196; inpatient: 262) total hip arthroplasties met inclusion criteria.</div></div><div><h3>Results</h3><div>Patients in the inpatient total knee arthroplasty group had a higher proportion of patients requiring an emergency department visit (11.4% vs 4.5%; <em>P =</em> .008) and admission (6.7% vs 2.7%; <em>P =</em> .025) within the first 90 days after surgery than the outpatient group; however, 2-year revision-free (97.9% vs 97.9%; <em>P =</em> .75) survival was similar between groups. Patients in the inpatient total hip arthroplasty group had a higher proportion of patients requiring an emergency department visit (13.0% vs 4.6%; <em>P =</em> .035) and admission (7.3% vs 1.0%; <em>P =</em> .018) within the first 90 days after surgery compared to the outpatient group; however, there was no difference in 2-year revision-free survival (96.4% vs 99.5%; <em>P =</em> .059).</div></div><div><h3>Conclusions</h3><div>Medically and socially complex patients undergoing TJA required additional resources during the 90-day postoperative window; however, they achieved similar survivorship as patients who met criteria for outpatient surgery.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101631"},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative vs Postoperative Patient Outcome and Recovery Expectations of Total Joint Arthroplasty","authors":"Siddhartha Dandamudi BBA ,&nbsp;Kyleen Jan MD ,&nbsp;Madelyn Malvitz BS ,&nbsp;Anne DeBenedetti MSc ,&nbsp;Omar Behery MD, MPH ,&nbsp;Brett R. Levine MD, MS","doi":"10.1016/j.artd.2025.101626","DOIUrl":"10.1016/j.artd.2025.101626","url":null,"abstract":"<div><h3>Background</h3><div>Patient satisfaction with total joint arthroplasty (TJA) remains a challenge, with up to 20% of patients expressing dissatisfaction despite good clinical outcomes. This study aims to assess patient expectations and experiences prior to and after undergoing a primary TJA.</div></div><div><h3>Methods</h3><div>A 13-question survey assessing patient expectations around surgical risks, logistics, physical therapy (PT), and pain was distributed in the clinics of multiple surgeons at an academic center. Each patient was categorized as either preoperative or postoperative, with similar questions for both groups. No identifying information was collected.</div></div><div><h3>Results</h3><div>One hundred eight preoperative and 344 postoperative responses were collected. Preoperatively, 91.3% of patients felt they had enough time to ask questions compared to 98.5% (<em>P</em> = .01) postoperatively. Preoperative patients named risks of TJA more accurately (<em>P</em> &lt; .00001). Expectations of long-term pain differed: 48.3% of preoperative patients expected no pain and 1.7% expected to be unable to move; postoperatively, 7.3% (<em>P</em> &lt; .0001) reported no pain and 10.3% (<em>P</em> = .03) were unable to move; 17.3% of patients finished PT within 2 weeks, compared to 1.7% who believed this was possible (<em>P</em> =.0027). A total of 73.1% of postoperative patients requested additional weeks of PT. Only 52.1% or patients had a long-term follow-up plan in place.</div></div><div><h3>Conclusions</h3><div>Expectations vary in patients undergoing TJA. Preoperative patients may have unrealistic expectations regarding postoperative pain and mobility. The need for more PT and the lack of a long-term follow-up plan highlight the importance of comprehensive perioperative communication to align expectations and potentially improve satisfaction and follow-up compliance.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101626"},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparison of Medial-congruent, Ultracongruent, and Cruciate-retaining Bearings Using a Single Cruciate-retaining Total Knee Design","authors":"Alexander V. Strait MS ,&nbsp;Eric J. Wilson MD ,&nbsp;Henry Ho MS ,&nbsp;Kevin B. Fricka MD ,&nbsp;Robert A. Sershon MD","doi":"10.1016/j.artd.2025.101632","DOIUrl":"10.1016/j.artd.2025.101632","url":null,"abstract":"<div><h3>Background</h3><div>Improving outcomes has driven advancements in total knee arthroplasty (TKA) bearing design. The aim of this study was to compare medial-congruent (MC), ultracongruent (UC), and cruciate-retaining (CR) TKA utilizing a single CR total knee system.</div></div><div><h3>Methods</h3><div>Six surgeons performed 2883 primary TKAs from 2012 to 2022 using the same implant design, comprised of 708 MC, 799 UC, and 1376 CR bearings. Prospectively collected data on clinical and patient-reported outcome measures were compared. Data analyses utilized analysis of variance tests for continuous data, <em>chi</em>-square tests for categorical data, and Mantel-Cox tests for survivorship analysis. MC subjects were older (MC = 67.5 vs UC = 65.3 vs CR = 66.7 years; <em>P</em> &lt; .001), had lower body mass index (MC = 32.4 vs UC = 33.1 vs CR = 33.2 kg/m²; <em>P</em> = .04), and had shorter mean follow-up (MC = 1.2 vs UC = 2.4 vs CR = 2.9 years; <em>P</em> &lt; .001).</div></div><div><h3>Results</h3><div>All groups experienced similar rates of 90-day complications (MC = 26/708, 3.7% vs UC = 39/799, 4.9% vs CR = 52/1376, 3.8%; <em>P</em> = .38) and revisions (MC = 1/708, 0.1% vs UC = 4/799, 0.5% vs CR = 5/1376, 0.4%; <em>P</em> = .49). Survivorship was similar at 2 years (<em>P</em> = .41) and above 98% at 5 years for all groups. At the 1-year follow-up, MC bearings had significantly greater Patient-Reported Outcomes Measurement Information System Global Health Physical (MC = 47.1 vs UC = 41.5 vs CR = 42.8; <em>P</em> &lt; .001) and mental scores (MC = 48.9 vs UC = 41.3 vs CR = 43.7; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>No differences in all-cause complications or revisions were observed for MC, UC, and CR bearings using the same total knee system. Clinically important differences favoring MC bearings were found with Patient-Reported Outcomes Measurement Information System Global Health Physical scores at 1 year; however, longer follow-up is necessary to determine if this trend holds.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101632"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: A Contemporary Analysis of Discharge Disposition Following Total Joint Arthroplasty","authors":"Francesco Pegreffi MD, PhD (Prof),&nbsp;Gianluca Costa MD (Dr),&nbsp;Arcangelo Russo MD (Prof),&nbsp;Raoul Saggini MD (Prof)","doi":"10.1016/j.artd.2025.101635","DOIUrl":"10.1016/j.artd.2025.101635","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101635"},"PeriodicalIF":1.5,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid-Term to Long-Term Outcomes of Total Hip Arthroplasty Using a Cementless Trochanteric Sparing Short Stem Through Direct Anterior Approach: A Single-Center Study","authors":"Seyed Mohammad Javad Mortazavi MD ,&nbsp;Pouya Tabatabaei Irani MD ,&nbsp;Mohammad Poursalehian MD ,&nbsp;Mahsa Mahanrad MD,&nbsp;Peyman Mirghaderi MD,&nbsp;Mohammadreza Razzaghof MD,&nbsp;Sadegh Saberi MD","doi":"10.1016/j.artd.2025.101623","DOIUrl":"10.1016/j.artd.2025.101623","url":null,"abstract":"<div><h3>Background</h3><div>Total hip arthroplasty (THA) is increasingly performed in younger patients, necessitating long-term femoral bone preservation. Metaphyseal engaging short stems offer potential benefits by reducing stress shielding and preserving bone stock. However, lacking long-term data in large quantities and younger patients in the literature led this study to assess mid-term to long-term outcome of these short stems.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated the long-term outcomes of 755 hips (667 patients) underwent THA using the Fitmore stem via a direct anterior approach. Clinical and radiographic assessments were conducted, and survival rates were determined using Kaplan-Meier analyses. Statistical analyses were performed to identify associations and predictors of stem revision.</div></div><div><h3>Results</h3><div>The overall survival rate for the Fitmore stem was 92.11% at an average follow-up of 10 years. No revisions were performed due to aseptic loosening of the femoral component. Stem revisions were performed in 20 hips, primarily due to periprosthetic fractures followed by periprosthetic joint infections and recurrent dislocations. The clinical outcomes showed significant improvements in HHS, WOMAC Index, and VAS pain scores. Radiographic analysis revealed acceptable rates of complications, with minimal stem subsidence, no severe bone loss, and a low incidence of radiolucent lines and cortical hypertrophy.</div></div><div><h3>Conclusions</h3><div>The Fitmore stem demonstrated favorable mid-term to long-term outcomes in terms of implant survival, functional scores, and radiographic assessments even in younger populations. The findings contribute to the existing body of knowledge on the Fitmore stem’s efficacy and safety in preserving bone and achieving satisfactory clinical outcomes in THA.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101623"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Assistance is Associated With No Intraoperative Fluoroscopy or Radiation Exposure During Direct Anterior Total Hip Arthroplasty","authors":"Sean Sequeira MD ,&nbsp;Alan Brett PhD ,&nbsp;Joseph Nessler MD ,&nbsp;Benjamin Frye MD ,&nbsp;Michael A. Mont MD","doi":"10.1016/j.artd.2025.101617","DOIUrl":"10.1016/j.artd.2025.101617","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;As more total hip arthroplasty (THA) procedures continue to be performed and concomitant intraoperative fluoroscopic utilization continues to increase, it is important for surgeons to critically analyze this practice during their procedures. The direct anterior approach (DAA) is a popular technique, but often requires the use of fluoroscopy for evaluation of component positioning and implantation. Computed tomography (CT)–based robotic-assisted THA (RA-THA) may represent an alternative to conventional procedures, which may allow the avoidance of the use of intraoperative fluoroscopy to be avoided and instead rely on a preoperative CT scan of the patient and intraoperative mapping. The purpose of this study was to evaluate the difference in radiation exposure from CT-based RA-THA DAA vs fluoroscopy-guided conventional THA DAA based on values from a cadaver study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;There were 2 surgeons who had previous extensive experience with the DAA, as well as conventional and RA-THA. They completed bilateral direct anterior THAs on 6 cadaver specimens. For each cadaver, a conventional THA with fluoroscopy was performed on the first hip, and a robotically assisted THA without fluoroscopy was performed on the contralateral hip. For all robotic-assisted cases, a preoperative 3-dimensional CT was performed. The radiation dosage from the preoperative scan was acquired through the radiation dose structured reports. Radiation exposure dosage for intraoperative fluoroscopy required tabulation of the number of fluoroscopy shots performed for each case as well as the length of time of exposure. This time was then converted to an effective radiation dose based on accepted standards, and this was multiplied by the average number of fluoroscopy shots per case to determine the average dosage per case.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;No fluoroscopic images were taken during the RA-THA using the DAA. There was a mean of 21 ± 8.9 fluoroscopic shots taken during each fluoroscopy-guided conventional THA using the DAA. The minimum number of fluoroscopic shots was 9, with a maximum of 31. Total radiation exposure ranged from 300 to 1033 mrem, with an average of 700 mrem. The average radiation exposure for a hip CT scan was 289 mrem.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In this cadaver-based study, the use of a CT-based RA-THA DAA eliminated the need for intraoperative fluoroscopy, removing the concern of radiation exposure to the surgeon and surgical staff. The CT-based RA-THA DAA does require a preoperative CT scan of the patient; however, the radiation dosage to the patient was equivalent to 8.7 intraoperative fluoroscopy shots. As more surgeons, patients, and surgical staff are exposed to an increasing number of orthopaedic procedures that require ionizing radiation to generate images, such as fluoroscopy and CT, it is important to consider the radiation dosage for all individuals and understand the posi","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101617"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143216125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Modified Wagner Stem Design Increases the Primary Stability in Cementless Revision Hip Arthroplasty","authors":"Julius M. Boettcher MSc ,&nbsp;Kay Sellenschloh Dipl. Ing ,&nbsp;Gerd Huber Dr. ,&nbsp;Benjamin Ondruschka Professor ,&nbsp;Michael M. Morlock Professor","doi":"10.1016/j.artd.2025.101622","DOIUrl":"10.1016/j.artd.2025.101622","url":null,"abstract":"<div><h3>Background</h3><div>Primary stability is of great importance for the longevity of the implant in cementless revision total hip arthroplasty, since instability is a major cause of rerevision. The purpose of this study was to evaluate the effect of an additional set of less prominent, wider splines added to an established conical stem design with sharp splines on axial stability in a model with significant proximal bone defects.</div></div><div><h3>Methods</h3><div>Twenty fresh-frozen human femurs were implanted with either the established or the additional spline design, dynamically loaded and tested in a load-to-failure configuration. Cortical contact in the femoral canal after implantation was evaluated by superimposing computed tomography scans and 3-dimensional laser scans. Stem subsidence and micromotion were evaluated to assess primary stability.</div></div><div><h3>Results</h3><div>Stems remained stable during cyclic loading of up to 200% body weight, except in bones with cortical bone mineral density below 1000 mgHA/mL. A significant reduction of more than 85% in stem subsidence (<em>P</em> = .040), axial micromotion (<em>P</em> = .007), and rotational micromotion (<em>P</em> = .010) was achieved with the new spline design. Load-to-failure testing exceeded 400% body weight.</div></div><div><h3>Conclusions</h3><div>The new spline design increased the cortical contact which resulted in increased axial primary stability in this in vitro experiment. Bone mineral density as a measure of bone quality proved to be a decisive factor for achieving immediate postoperative stability. Further variations of the established stem designs could further improve the longevity of artificial joint replacements.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"32 ","pages":"Article 101622"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Robotic Technique for Mapping Patellofemoral Kinematics in Total Knee Arthroplasty","authors":"Edward O’Bryan MBBS (Hons), FRACS, FAOA ,&nbsp;Christopher Jones MBBS, FRACS, FAOA ,&nbsp;Samuel Joseph MBBS, FRACS, FAOrthoA","doi":"10.1016/j.artd.2024.101610","DOIUrl":"10.1016/j.artd.2024.101610","url":null,"abstract":"<div><div>Computer assistance has significantly improved precision in total knee arthroplasty (TKA). Current robotic systems address tibiofemoral kinematics, ignoring the patellofemoral joint. This described TKA technique allows assessment and adjustment of patellofemoral kinematics. Reproducible landmarks on the tibial tubercle, trochlea, and patella are defined. With the “Special Point” function of the CORI surgical system, arcs of points are recorded dynamically. This records trochlear groove translation, patellar tracking, patellar tilt, and tibial tubercle rotation. During implant trials, special points are recollected to determine how these four parameters have changed compared to the native knee. Component adjustments can be made to optimize patellofemoral kinematics without compromising tibiofemoral balance. This may be a tool to mitigate patellofemoral maltracking and may improve TKA outcomes. Further studies are required to investigate outcomes.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101610"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Cementless Hip Arthroplasty Stem Types Based on Consolidated Large Registry Data","authors":"Logan E. Finger MD ,&nbsp;Matthew F. Gong MD ,&nbsp;Asher Mirvish BS ,&nbsp;Alexandra S. Gabrielli MD ,&nbsp;Ahmad P. Tafti PhD ,&nbsp;Michael J. O’Malley MD ,&nbsp;Brian A. Klatt MD ,&nbsp;Johannes F. Plate MD, PhD","doi":"10.1016/j.artd.2024.101582","DOIUrl":"10.1016/j.artd.2024.101582","url":null,"abstract":"<div><h3>Background</h3><div>Improvements in cementless total hip arthroplasty have been directed at optimizing osseointegration of the femoral implant to reduce aseptic loosening rates. Stem design plays a critical role in the performance of these implants. Given the increase in new stem designs and the creation of an updated classification system, improved understanding of the outcomes of each stem type is warranted. The purpose of this study was to determine overall revision rates based on stem design and proprietary model.</div></div><div><h3>Methods</h3><div>Joint registry data on the reported overall cases and revisions for each cementless stem brand were collected from the annual reports of the American Joint Replacement Registry (2021), United Kingdom National Joint Registry (2021), New Zealand Joint Registry (2020), and Australian Orthopaedic Association National Joint Replacement Registry (2021). Each individual stem brand was classified into a stem type derived from the classification system described by Radaelli et al.</div></div><div><h3>Results</h3><div>The most utilized stem types were (1) type B2 stems, (2) type A stems, and (3) type C1 stems. The most utilized stem models were the (1) Corail stem (B2), (2) Accolade II (type A), and (3) Taperloc 133 (type A). The highest and lowest overall revision rates observed were in the type B1 stems (8.09%) and type C3 stems (1.12%), respectively. The 3 stem models with the highest overall revision rates were the Synergy HA stem (9.04%), CBC stem (8.59%), and CLS stem (7.96%). The 3 stems with the lowest respective overall revision rates were the C2 stem (0.00%, 0 of 933 cases), Actis Duofix (0.59%), and VerSys stem (0.89%).</div></div><div><h3>Conclusions</h3><div>Based on consolidated large registry data, some cementless femoral stem types and models appear to perform better than others when compared on the basis of stem design.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"31 ","pages":"Article 101582"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11715119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}