26dkou061 10.3205/26dkou061 urn:nbn:de:0183-26dkou0618 Meeting Abstract Öttl Öttl Felix Conrad FC

Balgrist, Zürich, Schweiz

author Andronic Andronic Octavian O

Universitätsklinik Balgrist, Zürich, Schweiz

author Dimitriou Dimitriou Dimitris D

Universitätsklinik Balgrist, Zürich, Schweiz

author Zingg Zingg Patrick P

Universitätsklinik Balgrist, Zürich, Schweiz

author Hoch Hoch Armando A

Universitätsklinik Balgrist, Zürich, Schweiz

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 061 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Abstracts | Implantatdesign und Primärimplantation der Hüft-TEP Berlin 20261020 20261023 DKOU26_Abs_2095 TextObjectives and questions: The influence of femoral offset on the survival of cementless femoral stems in total hip arthroplasty (THA) remains unclear. This study aimed to evaluate the influence of total femoral offset (TFO – stem + head) on the risk of revision for early aseptic femoral loosening (AFL) and all-cause revision (ACR).Material and methods: A retrospective cohort study was conducted using data from the Swiss National Implant Registry (SIRIS) for all primary, cementless THAs performed for osteoarthritis between 2012 and 2024 with the five most common stem designs. The final cohort consisted of 93,027 hips. The primary exposure was TFO, analyzed as both a continuous variable and as three categories (<42 mm, 42–48 mm, and >48 mm). The primary endpoint was revision surgery for AFL, and the secondary endpoint was ACR. Kaplan-Meier survival analyses and multivariable Cox proportional hazards models were used to estimate survival and hazard ratios (HRs) while adjusting for confounders.Results: A total of 419 revisions for AFL and 2,592 for ACR were observed. The 10-year implant survival for AFL was significantly lower in the high-offset group (98.9%, 95% CI 98.6–99.1%) compared to the standard (99.3%, 95% CI 99.2–99.4%) and low-offset groups (99.5%, 95% CI 99.4–99.6%; p < 0.001). After adjusting for confounders, the risk of revision for AFL increased by 4.1% for every 1-mm increase in TFO (HR 1.04, 95% CI 1.02–1.06). The high-offset group (>48 mm) had a significantly increased risk of revision for AFL (HR 1.83, 95% CI 1.28–2.63) and ACR (HR 1.20, 95% CI 1.04–1.38). Most common causes of revision Infection 23.7%. Aseptic femoral loosening 14.5%. Femoral periprosthetic fracture Vancouver type B 12.2%. Dislocation/instability 11.9%. Leg length discrepancy due to acetabular malposition 7.9%.Discussion and conclusions: In this registry population, higher TFO combinations are associated with an 83% and 20% increased risk of revision for aseptic femoral loosening and a risk of all-cause revision, following cementless THA. Collars were associated with a 50% reduction in revision risk. 0 0 0 0