Related Experiment Video
Updated: Feb 23, 2026
Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
Proximal stress shielding is decreased with a short stem compared with a traditional-length stem in total shoulder
Patrick J Denard1, Matthew P Noyes2, J Brock Walker3
1Southern Oregon Orthopedics, Medford, OR, USA; Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
Background:
This study compared the outcome and radiographic humeral adaptations after placement of a traditional-length (TL) or short-stem (SS) humeral component during total shoulder arthroplasty (TSA). The hypothesis was there would be no difference in outcome or radiographic adaptations.
Methods:
A multicenter retrospective review was performed of primary TSAs performed with a TL or SS press-fit humeral component. The stems were identical in geometry and coating, with the only variable being stem length. Functional outcome and radiographs were reviewed at a minimum of 2 years postoperatively in 58 TL stems and 56 SSs.
Results:
There were significant improvements in all range of motion and functional outcome from baseline (P < .001) but no difference between the groups (P > .05). TL stems were placed in anatomic alignment 98% of the time compared with 86% of the SS cases (P = .015), but alignment did not influence outcome. Cortical thinning was more common in the medial metaphysis with the TL stem (74%) than with the SS (50%; P = .008). Partial calcar osteolysis was seen in 31% of TL stems and in 23% of SSs (P = .348). There was no difference in loosening or shift between the 2 groups.
Conclusion:
There is no difference in functional outcome at short-term follow-up between a TL stem and a SS in TSA. The pattern of radiographic adaptations may differ based on stem length. Further study is needed to evaluate the mid- to long-term differences, particularly with regard to calcar osteolysis.
