Abstract
Background: In 2016, the CPT stem replaced the Exeter stem as the main cemented stem at our institution. We assessed the prevalence of revision for periprosthetic femoral fracture (PFF) in patients operated on with either CPT or Exeter stem and compared the risk for revision between these stems. Methods: Primary total hip arthroplasties either performed in 2012-2015 with Exeter stem (n = 1443) or in 2017-2018 with CPT stem (n = 1322) were included. The prevalence of revision for PFF was compared. The Kaplan-Meier estimated survivorships were calculated for the 2 stem designs. The risk for revision was analyzed using the Cox proportional hazard regression model. Results: At 2 years, PFF was the most common reason for revision in the study population (1.3% prevalence, comprising 35% of all revisions). Moreover, 1.6% (95% confidence interval [CI] 1.0-2.4) of the CPT and 1.0% (95% CI 0.6-1.6) of the Exeter stems had been revised due to PFF. The 3-year Kaplan-Meier probability estimates for all-cause revision were 4.8% for the CPT (95% CI 3.6-6.0) and 3.3% for the Exeter stem (95% CI 2.3-4.3). The hazard ratio for revision due to any reason was 1.1 (95% CI 0.3-3.8) during the first 2 weeks, and 1.8 (95% CI 1.2-2.7, P = .006) from 2 weeks onwards for the CPT compared with the Exeter stem. Conclusion: The considerable number of PFF revisions with taper-slip stems, especially with CPT stems, is a matter of concern. Alternative cemented stems should be considered in patients at high risk for PFF.
Original language | English |
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Pages (from-to) | 3703-3708.e2 |
Journal | Journal of Arthroplasty |
Volume | 36 |
Issue number | 11 |
DOIs | |
Publication status | Published - 24 Jun 2021 |
Publication type | A1 Journal article-refereed |
Keywords
- cemented stem
- complication
- periprosthetic femoral fracture
- primary
- taper-slip stem
- total hip arthroplasty
Publication forum classification
- Publication forum level 1
ASJC Scopus subject areas
- Orthopedics and Sports Medicine