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Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Updated: Aug 18, 2025

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Could Short Stems THA Be a Good Bone-Saving Option Even in Obese Patients?

Michela Saracco1,2, Andrea Fidanza3, Stefano Necozione4

  • 1"A. Gemelli" IRCCS University Hospital Foundation, Catholic University of Sacred Heart, 00168 Rome, Italy.

Journal of Clinical Medicine
|December 11, 2022
PubMed
Summary

Short femoral stems offer bone preservation for hip replacement in obese patients. This study found comparable clinical and radiographic outcomes between short stems and traditional implants in this population.

Keywords:
THAmini-invasive THAobesityosteoarthritisshort stemsstemless hip prosthesestotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Short femoral stems are increasingly used in hip replacement, particularly for younger, active patients, aiming to preserve bone stock.
  • Obesity is a growing concern in younger demographics, presenting unique challenges for joint replacement surgery.

Purpose of the Study:

  • To evaluate the efficacy and safety of short femoral stems compared to traditional hip prostheses in obese patients (BMI ≥ 30 Kg/m²).

Main Methods:

  • A prospective case-series study involving 77 obese patients (49 with short stems, 28 with traditional stems) undergoing hip replacement for osteoarthritis or avascular necrosis.
  • Clinical outcomes (Harris Hip Score, WOMAC, VAS, SF-12) and radiographic evaluations were assessed at a mean follow-up of 42.6 months.
  • Statistical analysis included chi-square, t-test, Wilcoxon Rank Sum Test, and 2-factor ANOVA, with radiological evaluations performed by three blinded surgeons.

Main Results:

  • Both short stem and traditional stem groups demonstrated significant improvements in pain and clinical scores post-surgery (p < 0.05), with no significant differences between groups at final follow-up.
  • Radiographic evaluations showed excellent positioning, osseointegration, and joint geometry restoration in all cases, with high inter-rater reliability (ICC > 0.80).
  • No significant differences in complications were observed, and no revisions were required during the study period.

Conclusions:

  • Short femoral stems are a viable option for hip replacement in obese patients, providing bone preservation benefits.
  • Short stems demonstrate comparable clinical and radiographic outcomes to traditional stems in the obese population, with a low complication rate.