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Updated: Jun 23, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Perspectives on metaphyseal conservative stems.
F Falez1, F Casella, G Panegrossi
1Department Orthopaedic and Traumatology, S. Spirito in Sassia Hospital, Largo Tevere in Sassia 1, 00100, Rome, Italy, f.falez@flashnet.it.
Tissue-sparing hip replacement surgery utilizes conservative stems to minimize bone and soft tissue damage. The Mayo stem demonstrates excellent mid-term survivorship and offers versatile revision options.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Materials Science
Background:
- Hip replacement surgery has evolved towards less invasive techniques.
- Tissue-sparing surgery principles guide the development of new implant designs.
- Conservative femoral stems aim to preserve bone and soft tissues.
Purpose of the Study:
- To analyze the technical and biomechanical characteristics of metaphyseal bone-stock-preserving hip stems.
- To evaluate the performance and survivorship of the Mayo stem.
- To explore the applicability and revision potential of these conservative stems.
Main Methods:
- Literature review of metaphyseal bone-stock-preserving stems.
- Analysis of personal experience with Mayo, Nanos, and Metha stems.
- Mid-term follow-up of 160 Mayo implants, including DEXA analysis.
Main Results:
- The Mayo stem showed 97.5% survivorship at a mean of 4.7 years with low aseptic loosening.
- DEXA analysis indicated good calcar loading but significant lateral load transfer.
- Conservative stems offer wide applicability and options for conservative revision.
Conclusions:
- Metaphyseal bone-stock-preserving stems represent an evolution in hip implant design.
- The Mayo stem demonstrates excellent mid-term outcomes and biomechanical properties.
- These stems provide versatile solutions for primary and revision hip arthroplasty.
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