Changes in Femoral Stem Geometry Reduce Intraoperative Femoral Fracture Rates in Total Hip Replacement

Abstract

Intraoperative fracture rates in total hip arthroplasty (THA) have been associated with unce-mented stems, anterolateral surgical approach, diagnoses other than osteoarthritis, and female gender. The purpose of this study was to investigate if changes in stem design would influence intraoperative fracture rates. 1497 THA with Bi-Metric stems were compared to 1277 THA with Echo Bi-Metric Full Proximal Profile stems and 366 THA with Echo Bi-Metric Reduced Proximal Profile stems. The intraoperative fractures rates were 5.48%, 1.41% and 1.37% for Bi-Metric and Echo Bi-Metric with standard and reduced proximal geometry stems, respectively. Stem survivor-ship with aseptic loosening as an endpoint was 100% in all cohorts at the final follow-up. We con-clude that changes in femoral stem geometry in uncemented THA reduce intraoperative fracture rates while preserving fixation.