The short stem: promises and pitfalls

• Published in: The bone & joint journal Vol. 95-B; no. 11 Suppl A; p. 57
• Main Authors: Stulberg, S D, Patel, R M
• Format: Journal Article
• Language: English
• Published: England 01-11-2013
• Subjects: Adolescent; Adult; Aged; Arthroplasty, Replacement, Hip - instrumentation; Bone Remodeling; Female; Femur - diagnostic imaging; Femur - surgery; Hip Prosthesis; Humans; Male; Middle Aged; Pilot Projects; Postoperative Complications; Prospective Studies; Prosthesis Design; Radiography; Survival Rate; Treatment Outcome; United States - epidemiology; Short stems; Uncemented total hip replacement; Metaphyseal-engaging femoral implants
• ISSN: 2049-4408
• DOI: 10.1302/0301-620X.95B11.32936

Conventional uncemented femoral implants provide dependable long-term fixation in patients with a wide range of functional requirements. Yet challenges associated with proximal-distal femoral dimensional mismatch, preservation of bone stock, and minimally invasive approaches have led to exploration into alternative implant designs. Short stem designs focusing on a stable metaphyseal fit have emerged to address these issues in total hip replacement (THR). Uncemented metaphyseal-engaging short stem implants are stable and are associated with proximal bone remodeling closer to the metaphysis when compared with conventional stems and they also have comparable clinical performances. Short stem metaphyseal-engaging implants can meet the goals of a successful THR, including tolerating a high level of patient function, as well as durable fixation.