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

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.