Systematic Review and Meta-Analysis of Studies Comparing the Rate of Post-operative Periprosthetic Fracture Following Hip Arthroplasty With a Polished Taper Slip versus Composite Beam Stem.

Abstract

BACKGROUND:

We compared the incidence of postoperative periprosthetic femoral fractures (POPFF) following hip arthroplasty with either a cemented polished taper slip (PTS) stem or a cemented composite beam (CB) stem in comparative studies.

METHODS:

A systematic review of comparative studies, written in English and published in peer-reviewed journals since the year 2000, was conducted. Study quality was assessed using the Newcastle-Ottawa scale.The overall study qualities were good. There were 913,021 patients from 18 cohorts included in the meta-analysis. There were 294,540 patients who received a CB stem and 618,481 received a PTS stem. Cohorts were classified as high- or low-risk for POPFF based on patient risk factors. A metanalysis was performed using a random effects model, and the relative incidence with 95% confidence intervals (CIs) was reported.

RESULTS:

The patients at low risk of POPFF had an incidence rate ratio of 3.14 (CI: 2.48, 3.98) for the PTS group versus the CB group. Whereas, the patients at high risk of POPFF had an incidence rate ratio of 9.87 (CI: 3.63, 26.80) for the PTS group versus the CB group.

CONCLUSIONS:

The risk of POPFF is lower when hip arthroplasty was performed using a CB stem versus a PTS stem. This protective effect was greatest in patients who had a higher risk of POPFF. Surgeons should consider the effect of cemented stem choice on the risk of subsequent periprosthetic femur fracture, particularly in frail or elderly patients who are at a higher risk of postoperative periprosthetic femoral fracture.

• Authors: Ahmed Mabrouk, Jacob R Feathers, Ansar Mahmood, Robert West, Hemant Pandit, Jonathan N Lamb
• Journal: The Journal of arthroplasty (J Arthroplasty) Vol. 39 Issue 1 Pg. 269-275 (Jan 2024) ISSN: 1532-8406 [Electronic] United States
• PMID: 37343648 (Publication Type: Meta-Analysis, Systematic Review, Journal Article)
• Copyright: Copyright © 2023 Elsevier Inc. All rights reserved.

Topics

• Humans
• Aged
• Periprosthetic Fractures (epidemiology, etiology, surgery)
• Arthroplasty, Replacement, Hip (adverse effects)
• Hip Prosthesis (adverse effects)
• Retrospective Studies
• Risk Factors
• Reoperation (adverse effects)
• Femoral Fractures (epidemiology, etiology, surgery)
• Prosthesis Design