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The Collum Femoris Preserving (CFP) stem, initially designed as an epiphyseal\u2010stabilized prosthesis, aims to preserve proximal bone and reduce stress shielding. However, long\u2010term observations have revealed unexpected proximal bone resorption and distal sclerosis, challenging this classification. This study aims to reassess the fixation pattern and long\u2010term complications of CFP stems to inform clinical decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2013Meier survival analysis was performed, with endpoints of prosthesis loosening and reoperation. Radiographic data were analyzed to evaluate periprosthetic bone remodeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 497 patients (705 hips) with a mean follow\u2010up of 10.4\u2009years were included. The long\u2010term 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\u2010stabilized prosthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The long\u2010term survival rate of the CFP prosthesis was 95.32%. Radiographic findings indicate that the CFP prosthesis should be considered a distal\u2010stabilized prosthesis rather than the traditionally regarded epiphyseal\u2010stabilized prosthesis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.70109","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T07:15:36Z","timestamp":1752822936000},"page":"2385-2396","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Collum Femoris Preserving Stem (<scp>CFP<\/scp>) an Epiphyseal\u2010Stabilized Prosthesis? 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