From the Research
Uncemented femoral stems in hip arthroplasty include several main types: tapered stems, anatomic stems, cylindrical stems, modular stems, and short stems, with the most recent and highest quality study 1 suggesting that cemented stems may be preferred in elderly patients with displaced femoral neck fractures due to lower risk of short-term complications.
Types of Uncemented Femoral Stems
- Tapered stems: narrow distally and achieve stability through wedge-fitting in the femoral canal, with popular designs including the Accolade and Corail stems.
- Anatomic stems: curved to match natural femoral anatomy and often feature metaphyseal filling, such as the ABG stem.
- Cylindrical stems: provide stability through distal fixation and are useful in revision cases.
- Modular stems: allow surgeons to independently adjust various components like neck length and offset, beneficial for complex anatomies.
- Short stems: preserve bone stock by focusing on metaphyseal fixation and are increasingly used in younger patients.
Key Considerations
- The choice between stem types depends on patient factors including age, bone quality, anatomy, and activity level, with the surgeon selecting the most appropriate design based on these considerations and their experience with particular systems.
- Uncemented stems typically feature porous or hydroxyapatite coatings to promote bone ingrowth for biological fixation, as supported by studies such as 2 and 3.
- Recent studies, including 4 and 1, highlight the importance of careful patient selection and consideration of the potential risks and benefits of uncemented versus cemented stems in different patient populations.