Early Outcomes of a Novel Collared Triple-Tapered Femoral System in Primary Total Hip Arthroplasty

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Abstract
Background and Objectives: Collared, triple-tapered femoral stems have gained increasing popularity in primary total hip arthroplasty (THA) due to their stable metaphyseal fixation and ability to restore native hip biomechanics. This study evaluated the short-term clinical and functional outcomes of a novel collared triple-tapered femoral stem design in primary THA. Materials and Methods: This was a retrospective review of all patients who underwent primary, elective THA using a collared, triple-tapered femoral system at a single, urban, high-volume, academic hospital between September 2024 and February 2025. All procedures were performed by fellowship-trained arthroplasty surgeons. A total of 101 patients (102 hips) with a median follow-up of 1.1 years (range, 1.0 to 1.4 years) were included. Results: Most procedures were performed for primary osteoarthritis (96%). Mean operative time, from skin incision to skin closure, was 93 min, and most femoral stems implanted had a high offset (89%). Most patients were discharged home (96%), with a mean length of stay of 27 h. Within 90 days, three patients were readmitted for surgery-related reasons: one for superficial wound dehiscence, and two for periprosthetic joint infection (PJI). One PJI was treated with irrigation and debridement, antibiotics, and implant retention (DAIR) two months after primary THA. The other required a DAIR three weeks after primary THA, followed by a single-stage revision one week later. No dislocations, periprosthetic fractures, mechanical failures, or aseptic revisions of the femoral stem occurred. All stems were well-fixed at the latest follow-up, with no aseptic loosening observed. Mean Hip disability and Osteoarthritis Outcome Score, Joint Replacement (HOOS, JR) improvement was 15.0 points at six weeks, 25.2 points at three months, and 45.3 points at one year. Conclusions: Our results support encouraging early outcomes with no femoral aseptic complications observed using this novel collared, triple-tapered femoral system. A longer follow-up period is needed to assess mid- and long-term durability.

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