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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Short bone-conserving stems in cementless hip arthroplasty.

Harpal S Khanuja1, Samik Banerjee2, Deepak Jain3

  • 1Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, 4942 Eastern Avenue, 6th Floor, Building A, Baltimore, MD 21224.

The Journal of Bone and Joint Surgery. American Volume
|October 17, 2014
PubMed
Summary

Short bone-conserving femoral stems in total hip arthroplasty aim to preserve bone. However, current evidence is weak, with some designs showing high complication rates, necessitating further research before widespread adoption.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Arthroplasty research

Background:

  • Short bone-conserving femoral stems are utilized in total hip arthroplasty to preserve proximal bone stock.
  • Distinct fixation principles and loading patterns necessitate a classification system for these stems to enable outcome comparisons.

Purpose of the Study:

  • To evaluate the current evidence regarding short bone-conserving femoral stems in total hip arthroplasty.
  • To provide recommendations for clinical usage based on available data.

Main Methods:

  • Systematic review of existing literature on short bone-conserving femoral stems.
  • Analysis of reported clinical outcomes, complications, and stem designs.

Main Results:

  • A weak recommendation can be made for certain stem designs due to low-quality evidence.
  • Some short stem designs cannot be recommended at this time.
  • A subset of designs reported high rates of stem malalignment, incorrect sizing, subsidence, and intraoperative fractures.

Conclusions:

  • Further high-quality evidence, including prospective multicenter randomized trials comparing short stems with standard stems, is required.
  • Widespread adoption of short bone-conserving femoral stems is not recommended until stronger evidence is available.