Live Date:
October 18, 2022
7:15 PM CST
Noncemented press-t femoral stems predominate in total hip arthroplasty for allage groups with generally excellent long-term survivorship. The 2021 American Joint Replacement Registry reports that 96% of all elective primary total hip arthroplasties used noncemented femoral implant fixation.Today, there are many styles of press-t stems, each with supposed benefits, based on a range of design philosophies. Design aspects to consider when selecting a stem are numerous, including stem geometry, stem length, collared or collarless, material properties, and surface structure. Although most stem designs demonstrate excellent results, the differences in stem designs are intimately linked to additional factors such as ease of use/implantation, percentage of surface osseointegration, overall bone removal versus bone stock preservation, subsequent femoral stress shielding, and consideration of complexity of later revision. A surgeon with a broad understanding and appreciation of femoral stem designs should be prepared to select between the multitude of options to best serve individual patients.
Learning Objectives
- Understand the fundamental similarities and differences between different stems designs (geometry, length, collar)
- Examine that one stem does not fit all
- Learn about stem selection for various femur types
- Identify that hip arthroplasty surgeons can benefit from familiarity with 4/5 different stem designs
