Survival analysis for all-cause revision following primary total hip arthroplasty with a medial collared, triple-tapered primary hip stem versus other implants in real-world settings

Chitnis, A.S.; Mantel, Jack; Ruppenkamp, J.; Bourcet, A.; Holy, Chantal E.

doi:10.1080/03007995.2020.1822309

Cited by 8 publications

(3 citation statements)

References 26 publications

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“…A total of 446 records were excluded by examining their titles and/or abstracts, leaving 40 records for full-text review. Twenty-nine studies were excluded after full-text review: ten because they reported on non-conventional-length (short, long) or non-HA-coated stems ( 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ), eight because they compared collared versus collarless stems with different designs or coatings ( 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ), five because they were letters to the editor, technical notes, or correspondence ( 38 , 39 , 40 , 41 , 42 ), three because they did not report on any outcomes ( 14 , 43 , 44 ), one because it compared hemiarthroplasty versus THA ( 45 ), one because it was a cadaveric study ( 46 ), and one because it was a non-comparative study ( 47 ). A further three articles were excluded because the outcomes of interest were not presented separately for collared versus collarless stems (the authors were contacted at least three times but none responded) ( 4 , 6 , 48 ).…”

Section: Resultsmentioning

confidence: 99%

Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis

Ait-Si-Selmi,

Vidalain,

Ramos-Pascual

et al. 2024

EFORT Open Reviews

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Purpose to systematically review comparative studies reporting revision rates, clinical outcomes, or radiographic outcomes of total hip arthroplasty (THA) using collared versus collarless conventional-length uncemented hydroxyapatite (HA)-coated stems. Methods In adherence with PRISMA guidelines, a literature search was performed on Medline, Embase, and Scopus. Comparative clinical studies were eligible if they reported outcomes of collared versus collarless uncemented HA-coated stems for primary THA. Two reviewers screened titles, abstracts, and full-texts to determine eligibility; then performed data extraction; and assessed the quality of studies according to Joanna Briggs Institute (JBI) checklist. Results The search returned 972 records, 486 were duplicates, and 479 were excluded after title/abstract/full-text screening. Three further studies were included from the references of eligible studies and from discussions with subject matter experts, resulting in 11 included studies. The JBI checklist indicated six studies scored ≥7 points and four studies ≥4 points. Pooled data revealed collared stems had significantly lower revision rates (OR = 0.45; 95% CI = 0.31–0.64) and subsidence (MD = −1 mm; 95% CI = −1.6–-0.3), but no significant difference in intraoperative complication rates (OR = 0.94; 95% CI = 0.67–1.32) in the short term to mid-term. Unpooled data indicated that collared stems provide equivalent survival, equivalent or better outcomes, and equivalent or lower complication rates. Conclusion In comparative studies, collared stems have lower revision rates than collarless stems, as well as equivalent or better clinical and radiographic outcomes. Differences could be due to a protective effect that the collar offers against subsidence, particularly in undersized or misaligned stems. Further studies are warranted to confirm long-term results and better understand differences between registry data and clinical studies.

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Section: Resultsmentioning

confidence: 99%

Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis

Ait-Si-Selmi,

Vidalain,

Ramos-Pascual

et al. 2024

EFORT Open Reviews

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“…Chitnis et al reported on their results using the MCTT stem in 1200 patients, extracted from a retrospective database. They found a lower revision rate at 3 years as compared to conventional hip stems (1.03% vs. 2.63%) [20]. The recent American Joint Replacement Registry (AJRR) data from 2020 also showed that the MCTT stem had the lowest revision rate at three years among all stems analyzed [21].…”

Section: Introductionmentioning

confidence: 99%

Five-Year Survivorship of Total Hip Arthroplasty With a Proximally Coated, Medially Collared, Triple-Tapered Femoral Stem: A Retrospective, Multicenter Registry Review

Hunter,

Fawley,

Diaz

et al. 2024

Cureus

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BackgroundThe anterior approach for total hip arthroplasty (THA) has gained popularity in recent years. Some surgeons have been hesitant to adopt the approach due to concerns over increased complications such as intraoperative fracture, stem loosening, and stem revision. This study aims to evaluate the all-cause revision rate and survivorship of a collared, triple-tapered stem that was designed specifically for use with the anterior approach in THA to enhance outcomes and reduce adverse events. MethodologyA retrospective outcomes review was conducted to assess survivorship and clinical outcomes for a specific proximally coated, medially collared triple-tapered (MCTT) femoral stem. ResultsIn a cohort of 5,264 hips, Kaplan-Meier survivorship estimates (95% confidence interval [CI]; N with further follow-up), with survivorship defined as no revision of any component for any reason at five years after the index procedure, were 98.9% (97.8%-99.4%; 43) under the clinical assumption and 99.6% (99.4%-99.7%; 894) under the registry assumption. With survivorship defined as stem revision for any reason, survivorship estimates at five years postoperatively were 99.6% (99.3%-99.8%; 43) under the clinical assumption and 99.8% (99.7%-99.9%; 894) under the registry assumption. The mean follow-up time was 94.52 days (standard deviation [SD] 2.24, range 90.03-96.02). At five years postoperatively, the mean Harris Hip Score was 95.19, and the mean Hip Disability and Osteoarthritis Outcome Score Junior (HOOS JR) score was 98.66. ConclusionsOur evaluation demonstrates excellent construct and stem survivorship and very low complication rates at midterm postoperative follow-up.

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“…Currently, cementless stems account for approximately 70% of THA cases [1,[4][5][6][7]. A t and ll type concept (collared and full hydroxyapatite coated) cementless stem (ACTIS stem; Depuy Synthes, Warsaw, IN, USA) has been available since 2016 and used in retrospective studies on THA [8][9][10]. However, there has been no study on BHA using this stem for treatment of femoral neck fractures.…”

Section: Introductionmentioning

confidence: 99%

Relationship between proximal femoral morphology and bone mineral density around the stem and the effects of osteoporosis treatment in patients with femoral neck fracture: a multicentre prospective cohort study

Oe,

Hayashi,

Fukui

et al. 2023

Preprint

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Background This study aimed to classify older patients with femoral neck fractures who underwent hemiarthroplasty using a full hydroxyapatite-collared compaction short stem to evaluate the change in bone mineral density (BMD) around the stem. Methods This multicentre, prospective study included 96 older patients with femoral neck fractures registered for surgery from November of 2018 to October of 2020, who were followed up for 1 year after surgery. The patients were classified into three types according to Dorr classification. The BMD around the stem of each patient was determined based on seven Gruen zones using dual-energy X-ray absorptiometry. Clinical scores were measured concurrently. Further, we compared the BMD change rate around the stem in terms of Dorr classification and clinical scores, and investigated the relationship between osteoporosis treatment intervention and the BMD change rate. Results After excluding patients with missing data, 40 patients were included in the analysis. The BMD change rate in zone 2 was significantly different between Dorr types B and C. Clinical scores did not significantly differ between the three groups. Regarding the relationship between osteoporosis treatment and BMD change rate, the pre-injury intervention group had significantly suppressed BMD change rate decline compared with the post-injury intervention and no-intervention groups in zones 1 and 7. Conclusion Careful follow-up examination is critical when performing hemiarthroplasty in patients with femoral neck fractures of Dorr type C because the BMD change rate may decline postoperatively. Pre-injury osteoporosis intervention therapy may suppress BMD loss around the stem.

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Survival analysis for all-cause revision following primary total hip arthroplasty with a medial collared, triple-tapered primary hip stem versus other implants in real-world settings

Abstract: Survival analysis for all-cause revision following primary total hip arthroplasty with a medial collared, triple-tapered primary hip stem versus other implants in real-world settings, Current Medical Research and Opinion,

Cited by 8 publications

References 26 publications

Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis

Outcomes of total hip arthroplasty using collared versus collarless uncemented HA-coated stems: a meta-analysis

Five-Year Survivorship of Total Hip Arthroplasty With a Proximally Coated, Medially Collared, Triple-Tapered Femoral Stem: A Retrospective, Multicenter Registry Review

Relationship between proximal femoral morphology and bone mineral density around the stem and the effects of osteoporosis treatment in patients with femoral neck fracture: a multicentre prospective cohort study

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