Slightly Reduced Early Subsidence with Similar Outcomes and Complications Rate in Collared Stems – A Systematic Review of Randomized Clinical Trials
Authors: Nerys-Figueroa J, Parsa A, Curley A, Charif S, Domb BG, Schinsky MF
Journal: Journal of Orthopaedics, April 2024
DOI: 10.1016/j.jor.2024.01.013
Objective
To compare early stability, outcomes, and complication rates between collared and collarless femoral stems in total hip arthroplasty.
Key Findings
- Collared stems demonstrate slightly less early implant subsidence.
- No significant differences were found in pain relief, patient satisfaction, or complication rates between stem types.
- Both collared and collarless stems provide good long-term clinical outcomes.
Conclusion
Collared stems may confer a minor early mechanical advantage, but both stem designs are clinically effective. Implant choice can be individualized based on surgeon preference and patient anatomy.
What Does This Mean for Providers?
- When selecting femoral stems for THA, recognize that collared stems may reduce early subsidence slightly.
- Understand that clinical outcomes and complications are similar between collared and collarless designs.
- Choose stem type based on individual patient factors and surgical judgment without concern for major differences in outcomes.
- Counsel patients that both stem options are effective for hip replacement success.