April 10, 2026
2 min read
Key takeaways:
- Incidence of periprosthetic fracture after THA was 1.8% with a dual-tapered collarless stem and 0.26% with a triple-tapered collared stem.
- The dual-tapered collarless stem also had more overall revisions.
NEW ORLEANS — Use of a triple-tapered collared stem in patients aged older than 70 years undergoing total hip arthroplasty may decrease the risk for periprosthetic fracture, according to results presented here.
“I personally do not think we should be using [triple-tapered collared] stems in every single patient. Cemented implants make sense for some patients, but that group is becoming smaller,” Jeremy M. Gililland, MD, professor of orthopedics at the University of Utah, told Healio. “It is not just about age; it is not just about sex. These stems do have a broad utility and can be used in a lot of patients. I do think it is going to change the way we think about stem choice in our patients undergoing total hip arthroplasty.”
Data were derived from Smith NS, et al. Paper 341. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 2-6, 2026; New Orleans.
Gililland along with Nolan S. Smith, MD, and colleagues retrospectively reviewed data from patients aged older than 70 years undergoing THA with either a dual-tapered collarless femoral stem (n = 383) or a triple-tapered collared stem (n = 370) across the University of Utah, Hospital for Special Surgery and the University of Louisville. Researchers compared overall revision rates, incidence of periprosthetic fractures, complications and patient-reported outcome measures between the two groups.
“We had a 1.8% incidence of periprosthetic fracture in the dual-tapered collarless group vs. a 0.26% incidence of fracture in the triple-tapered collared group, and then more overall revisions in the dual-tapered group, as well,” Smith, an orthopedic surgeon in Louisville, Kentucky, said in his presentation at the American Academy of Orthopaedic Surgeons.
According to Gililland, future research should compare different cement and stem types as well as classifying bone type to further understand which implants are best for which patients.
Jeremy M. Gililland
“There is more research in the arena on stem choice for patients to minimize periprosthetic fracture risk because periprosthetic fracture is a devastating complication for our patients. We all want to minimize that down to near zero and we would love it to be zero,” Gililland told Healio. “It is hard to make any complication completely zero, but we want to try to get there with this complication. I do think there is more research coming on stem choice, but these papers provide some information to surgeons about stems that are lower risk for their patients, especially the elderly patients.”
For more information:
Jeremy M. Gililland, MD, can be contacted at jeremy.gililland@hsc.utah.edu.
Sources/Disclosures
Source:
Smith NS, et al. Paper 341. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 2-6, 2026; New Orleans.
Disclosures:
Gililland reports being a consultant for Stryker. Smith reports no relevant financial disclosures.
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