J Korean Med Sci.  2022 Feb;37(6):e41. 10.3346/jkms.2022.37.e41.

Do Cementless Short Tapered Stems Reduce the Incidence of Thigh Pain After Hip Arthroplasty? Systematic Review and Meta-Analysis

• Yoo JI
• Cha Y
• Lee YK
• Ha YC
• Koo KH

• KMID: 2526030
• DOI: http://doi.org/10.3346/jkms.2022.37.e41

Abstract

Background
The purpose of this study was to determine whether short tapered stems reduce the rate of thigh pain through a systematic review and meta-analysis of comparative studies between short tapered stems and standard-length tapered stems.
Methods
We conducted a meta-analysis of comparative studies: 1) retrospective studies and 2) randomized controlled trials (RCTs), on 2 stem designs: short tapered stem versus standard-length tapered stem. Studies were selected by means of the following criteria: 1) study design: retrospective comparative studies, prospective comparative studies, RCTs; 2) study population: patients with total hip arthroplasty or hemiarthroplasty for hip disease or hip fracture; 3) intervention: short tapered stem and standard tapered stem; and 4) outcomes; thigh pain, other clinical results.
Results
Among the 250 articles that were identified at the initial search, 6 studies, 4 RCTs and 2 retrospective comparative studies, were included in this meta-analysis. In the analysis of retrospective studies, the short tapered stem reduced the risk of thigh pain compared to the standard tapered stem (risk ratio [RR] = 0.13; 95% confidence interval [CI], 0.02–0.09; Z = −2.07; P = 0.039). However, in the analysis of RCTs, the incidence of thigh pain was similar between the two stem designs (RR = 1.21; 95% CI, 0.76–1.93; Z = 0.82; P = 0.410). Overall meta-analysis including all studies showed that the short tapered stem did not reduce the incidence of thigh pain compared to the standard-length tapered stem (RR = 0.91; 95% CI, 0.59–1.40; Z = −0.44, P = 0.663).
Conclusions
We did not find a significant difference in the incidence of thigh pain between short tapered stem and standard tapered stem in hip arthroplasty.

Keyword

Hip Arthroplasty; Short Tapered Stem; Standard Tapered Stem; Thigh Pain

Figure

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  Fig. 1 PRISMA flow diagram outlining the clinical study selection process.PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

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  Fig. 2 A forest plot of a comparative meta-analysis between short tapered stem and standard tapered stem in all studies.RR = risk ratio, CI = confidence interval.

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  Fig. 3 A forest plot of a comparative meta-analysis between short tapered stem and standard tapered stem in randomized controlled studies.RR = risk ratio, CI = confidence interval.

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  Fig. 4 A forest plot of a comparative meta-analysis between short tapered stem and standard tapered stem in retrospective studeis.RR = risk ratio, CI = confidence interval.

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