Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases

ABSTRACT Background The global increase in total hip arthroplasty (THA) has led to widespread use of cementless femoral stems. The Collum Femoris Preserving (CFP) stem, initially designed as an epiphyseal‐stabilized prosthesis, aims to preserve proximal bone and reduce stress shielding. However, lon...

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Main Authors: Yansong Liu, Yongbo Ma, Xuzhuang Ding, Jiangqi Chang, Mengnan Li, Tao Wu
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.70109
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author Yansong Liu
Yongbo Ma
Xuzhuang Ding
Jiangqi Chang
Mengnan Li
Tao Wu
author_facet Yansong Liu
Yongbo Ma
Xuzhuang Ding
Jiangqi Chang
Mengnan Li
Tao Wu
author_sort Yansong Liu
collection DOAJ
description ABSTRACT Background The global increase in total hip arthroplasty (THA) has led to widespread use of cementless femoral stems. The Collum Femoris Preserving (CFP) stem, initially designed as an epiphyseal‐stabilized prosthesis, aims to preserve proximal bone and reduce stress shielding. However, long‐term observations have revealed unexpected proximal bone resorption and distal sclerosis, challenging this classification. This study aims to reassess the fixation pattern and long‐term complications of CFP stems to inform clinical decision‐making. Methods Between 2006 and 2012, 497 patients (705 hips) were included. The primary outcomes included prosthesis survival, periprosthetic bone remodeling, and clinical outcomes, assessed using the Harris Hip Score (HHS). Kaplan–Meier survival analysis was performed, with endpoints of prosthesis loosening and reoperation. Radiographic data were analyzed to evaluate periprosthetic bone remodeling. Results A total of 497 patients (705 hips) with a mean follow‐up of 10.4 years were included. The long‐term survival rate of the CFP stem was 95.32%, with a 97.2% survival rate for aseptic loosening and 95.5% for reoperation. Complications included 2.84% aseptic loosening, 0.99% infection, 0.99% periprosthetic fractures, 0.57% dislocation, and 1.42% heterotopic ossification. The CFP stem, which has not shown signs of aseptic loosening, exhibits radiographic features characteristic of a distal‐stabilized prosthesis. Conclusion The long‐term survival rate of the CFP prosthesis was 95.32%. Radiographic findings indicate that the CFP prosthesis should be considered a distal‐stabilized prosthesis rather than the traditionally regarded epiphyseal‐stabilized prosthesis.
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spelling doaj-art-425fdc06814140bfb0b298a494c450e22025-08-04T03:33:16ZengWileyOrthopaedic Surgery1757-78531757-78612025-08-011782385239610.1111/os.70109Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 CasesYansong Liu0Yongbo Ma1Xuzhuang Ding2Jiangqi Chang3Mengnan Li4Tao Wu5Department of Orthopaedic Surgery The Third Hospital of Hebei Medical University Shijiazhuang Hebei People's Republic of ChinaDepartment of Orthopaedic Surgery The Third Hospital of Hebei Medical University Shijiazhuang Hebei People's Republic of ChinaDepartment of Orthopaedic Surgery The Third Hospital of Hebei Medical University Shijiazhuang Hebei People's Republic of ChinaDepartment of Orthopaedic Surgery The Third Hospital of Hebei Medical University Shijiazhuang Hebei People's Republic of ChinaDepartment of Orthopaedic Surgery The Third Hospital of Hebei Medical University Shijiazhuang Hebei People's Republic of ChinaDepartment of Orthopaedic Surgery The Third Hospital of Hebei Medical University Shijiazhuang Hebei People's Republic of ChinaABSTRACT Background The global increase in total hip arthroplasty (THA) has led to widespread use of cementless femoral stems. The Collum Femoris Preserving (CFP) stem, initially designed as an epiphyseal‐stabilized prosthesis, aims to preserve proximal bone and reduce stress shielding. However, long‐term observations have revealed unexpected proximal bone resorption and distal sclerosis, challenging this classification. This study aims to reassess the fixation pattern and long‐term complications of CFP stems to inform clinical decision‐making. Methods Between 2006 and 2012, 497 patients (705 hips) were included. The primary outcomes included prosthesis survival, periprosthetic bone remodeling, and clinical outcomes, assessed using the Harris Hip Score (HHS). Kaplan–Meier survival analysis was performed, with endpoints of prosthesis loosening and reoperation. Radiographic data were analyzed to evaluate periprosthetic bone remodeling. Results A total of 497 patients (705 hips) with a mean follow‐up of 10.4 years were included. The long‐term survival rate of the CFP stem was 95.32%, with a 97.2% survival rate for aseptic loosening and 95.5% for reoperation. Complications included 2.84% aseptic loosening, 0.99% infection, 0.99% periprosthetic fractures, 0.57% dislocation, and 1.42% heterotopic ossification. The CFP stem, which has not shown signs of aseptic loosening, exhibits radiographic features characteristic of a distal‐stabilized prosthesis. Conclusion The long‐term survival rate of the CFP prosthesis was 95.32%. Radiographic findings indicate that the CFP prosthesis should be considered a distal‐stabilized prosthesis rather than the traditionally regarded epiphyseal‐stabilized prosthesis.https://doi.org/10.1111/os.70109CFP stem prosthesisdistal‐stabilizedretrospectivetotal hip arthroplasty
spellingShingle Yansong Liu
Yongbo Ma
Xuzhuang Ding
Jiangqi Chang
Mengnan Li
Tao Wu
Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases
Orthopaedic Surgery
CFP stem prosthesis
distal‐stabilized
retrospective
total hip arthroplasty
title Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases
title_full Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases
title_fullStr Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases
title_full_unstemmed Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases
title_short Is Collum Femoris Preserving Stem (CFP) an Epiphyseal‐Stabilized Prosthesis? A Long‐Term Single‐Center Series Follow Up of 705 Cases
title_sort is collum femoris preserving stem cfp an epiphyseal stabilized prosthesis a long term single center series follow up of 705 cases
topic CFP stem prosthesis
distal‐stabilized
retrospective
total hip arthroplasty
url https://doi.org/10.1111/os.70109
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