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Updated: Jan 3, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
A short stem with metaphyseal anchorage reveals a more physiological strain pattern compared to a standard stem - an
Thilo Floerkemeier1, Jennifer Weltin1, Stefan Budde2
1Hannover Medical School, Department of Orthopaedic Surgery, Hannover, Germany.
Purpose:
The proposed advantages of short stem hip arthroplasties are bone preserving strategies and less soft tissue damage. Bone preserving strategies do not only include a more proximal resection of the femoral neck, but especially for short stem hip arthroplasties with predominantly metaphyseal fixation a presumed more physiologic load transfer and thus a reduction of stress-shielding. However, the hypothesized metaphyseal anchorage associated with the aforementioned benefits still needs to be verified. Unfortunately, mid- to long-term clinical studies are missing.
Methods:
Therefore, the METHA short stem as a short stem with proposed metaphyseal anchorage and the Bicontact® standard stem were tested biomechanically in three pairs of cadaveric femora while strain gauges monitored their corresponding strain patterns.
Results:
For the METHA stem, the strains in all tested locations including the region of the calcar were similar to conditions of cadaver without implanted stem. The Bicontact stem showed approximately half of strain of the non-implanted cadaveric femura with slightly increasing strain from proximal to distal.
Conclusions:
Summarizing, the current study revealed primary metaphyseal anchorage of the METHA short stem and a metaphyseal-diaphyseal anchorage of the Bicontact stem.
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