The following is a summary of “Risk factors for templating mismatch of uncemented stems in bipolar hemiarthroplasty for femoral neck fracture,” published in the November 2023 issue of Surgery by Kim et al.

Precise preoperative templating plays a crucial role in optimizing outcomes in hip arthroplasty. Despite meticulous planning, unexpected implant mismatches can arise, impacting surgical success. Their investigation delved into identifying the risk factors associated with oversized and undersized stem mismatches, specifically in uncemented hemiarthroplasty utilizing a double-tapered wedge rectangular stem for femoral neck fractures.

Researchers conducted an analysis involving 154 consecutive patients who underwent hemiarthroplasty for femoral neck fractures, categorizing 104 patients into three groups: oversized (n = 17; 16.3%), matched (n = 80; 76.9%), and undersized stem groups (n = 7; 6.7%). Their findings unveiled several significant associations. A smaller femoral head offset exhibited a noteworthy association with oversized stem insertion (odds ratio [OR] = 0.89, 95% confidence interval [95% CI] = 0.81–0.98, P = 0.017), alongside a smaller isthmus diameter (OR = 0.57, 95% CI = 0.35–0.92, P = 0.021), and a reduced canal flare index (OR = 0.20, 95% CI = 0.04–0.98, P = 0.047) in logistic regression models.

Moreover, their analysis highlighted older age as a significant factor associated with undersized stem insertion (OR = 1.18, 95% CI = 1.01–1.39, P = 0.037). These correlations underscore the importance of meticulously considering proximal femoral geometry and patient age during preoperative planning when performing hemiarthroplasty for femoral neck fractures using a double-tapered wedge rectangular stem.

Their study emphasizes the critical nature of surgeon vigilance and thorough consideration of specific anatomical parameters and patient demographics in preoperative planning to mitigate the risk of stem mismatch during hemiarthroplasty procedures for femoral neck fractures. Such meticulous attention during planning stages holds the potential to avert complications associated with implant mismatches and contribute to improved surgical outcomes.

Source: nature.com/articles/s41598-023-48538-y