What role for short stems in 2023?

Area of Science:

• Orthopedic surgery
• Biomaterials engineering
• Surgical innovation

Background:

• Current total hip replacement trends focus on tissue and bone conservation.
• Decreasing patient age raises concerns about iterative revision surgeries.
• Short stems are proposed as a femoral solution to address revision challenges.

Purpose of the Study:

• To define "short" stems and differentiate them from shortened standard stems.
• To explore indications, contraindications, and learning curves for short stem implantation.
• To assess the real-world advantages, complications, and role of short stems in hip arthroplasty.

Main Methods:

• Expert opinion review of current short stem technology and literature.
• Analysis of implantation technique differences and specific requirements.
• Comparative assessment of short stem outcomes versus standard stems, focusing on complications.

Main Results:

• Short stems offer potential benefits like personalized biomechanics and reduced hip pain.
• Implantation requires specific techniques and rigor, with a learning curve involved.
• Widespread adoption varies, and their advantages need validation against theoretical claims.

Conclusions:

• Short stems represent a potential paradigm shift in hip arthroplasty, aiming for bone preservation and easier revisions.
• Further rigorous assessment is needed to confirm their clinical utility and establish their role.
• Understanding their specific indications and mastering implantation techniques are crucial for optimal outcomes.