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Updated: Apr 15, 2026
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
12.6K
10-year experience with short stem total hip arthroplasty
Orthopedics
|April 1, 2015
Summary
Revision of short stem total hip arthroplasty (THA) is uncommon. Mechanical complications like neck adapter failure and aseptic loosening led to revision in 38 cases, with a low overall revision rate.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- Short stem total hip arthroplasty (THA) has been utilized since 1998.
- Currently, 30% of THAs at the authors' institution employ short stems.
Observation:
- A review of 1953 Metha short stem THAs (September 2005 - February 2012) identified 38 revisions for mechanical complications.
- Complications included modular neck adapter failure (12 cases), aseptic implant loosening (19 cases, 11 with stem subsidence), via falsa (2 cases), and periprosthetic fractures (5 cases).
Findings:
- The aseptic revision rate was 1.3% for short stems and 1.9% for all documented revisions.
- Revision strategies involved standard stems (34), short stems (2), and long revision stems (2).
- Aseptic revisions were associated with undersizing (58%), male patients (54%), osteonecrosis (23%), and varus positioning in coxa vara (7%).
Implications:
- Short stem THA with the Metha implant is a bone-preserving option for select patients and indications.
- Early stem subsidence and valgus positioning were more prevalent in female patients requiring revision.
- No revisions were attributed to dislocation or femoral thigh pain, suggesting implant-specific advantages in these areas.
