The short-term outcomes of cementless collared triple-tapered stem for primary total hip arthroplasty in patients ≥70-years old

Background

Periprosthetic fractures and mechanical failure following total hip arthroplasty (THA) are not uncommon occurrences in elderly patients, especially with the use of cementless implants. The utilization of collared, triple-tapered femoral stems has demonstrated good clinical outcomes and results comparable to other femoral stems. There remains a paucity of literature on the use of these stems in older patients. In this study, we evaluated post-operative outcomes following primary THA in patients ≥70-years old using a collared, triple-tapered femoral stem.

Methods

Retrospective study including 91 primary THAs in patients ≥70-years old using a triple-tapered femoral stem, between September 2017 and July 2024. Primary outcomes included intraoperative or post-operative periprosthetic fractures and subsidence of the femoral stem. Subsidence was measured on x-rays as the distance between the most proximal aspect of the greater trochanter and the shoulder of the femoral stem.

Results

A total of 91 patients were included, with no periprosthetic fractures observed intraoperatively or post-operatively. The average femoral stem subsidence at 6-weeks post-operative was 1.1 mm (std dev, 0.9) compared to baseline post-operative imaging. At that time point three patients had subsidence ≥3 mm, with no clinically significant symptoms. There was one prosthetic joint infection requiring revision and three superficial surgical site infections. The overall average follow-up time was 12.5 months (std dev, 12.7).

Conclusion

In this study, we found low rates of subsidence and no periprosthetic fractures following primary THA with triple-taper stems in patients ≥70-years old. Of note, no revision surgeries were performed for mechanical failure.