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Related Experiment Video

Updated: May 21, 2025

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

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Do Cumulative Revision Rate and First-time Re-revision Rate Vary Between Short and Standard Femoral Stem Lengths? A

Karin Rilby1,2,3, Mirthe H W van Veghel4, Maziar Mohaddes1,3,5,6

  • 1Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenberg, Sweden.

Clinical Orthopaedics and Related Research
|May 19, 2025
PubMed
Summary

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Similar patient-reported outcomes 6 months after unicompartmental and total knee replacement for osteoarthritis: a prospective cohort study of 60,145 patients from the Australian Orthopaedic Association National Joint Replacement Registry.

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Association between intraoperative fluoroscopy for anterior approach total hip arthroplasty and short-term revision risk: an analysis based on 49,878 cases from the Dutch Arthroplasty Register.

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No difference in patient-reported outcome measures between private and public hospitals in the Netherlands: a cross-sectional analysis based on 170,150 hip and knee arthroplasties from the Dutch Arthroplasty Register.

Acta orthopaedica·2026

Short-stem total hip arthroplasty (THA) revision often uses standard stems, but survivorship is similar to standard-stem THA. This suggests short stems may offer a bone-preserving advantage during revision surgery.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Medical device engineering

Background:

  • Short-stem total hip arthroplasty (THA) is advocated for preserving proximal femoral bone, but evidence is limited.
  • The risk of premature revision for short-stem THA requires investigation.
  • Registry data on stem types in first-time revisions and survivorship of short vs. standard stems are lacking.

Purpose of the Study:

  • To determine the types of stems used in first revisions of primary short-stem and standard-stem THAs.
  • To compare the overall cumulative revision rate (CRR) of primary short-stem THAs versus standard-stem THAs.
  • To compare the overall cumulative re-revision rate of primary short-stem THAs versus standard-stem THAs.

Main Methods:

  • A comparative study using data from the Australian, Dutch, and Swedish national joint replacement registries (2007-2022).

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  • Included 15,771 short-stem THAs and 31,542 propensity score-matched standard-stem THAs.
  • Kaplan-Meier survival analyses were used to calculate CRRs at 12 years for primary THAs and 5 years for first-time revisions.

    • Main Results:

    • Standard stems were more frequently used in first-time revisions of short-stem THAs (58%) compared to standard-stem THAs (46%).
    • No significant difference in 12-year overall CRRs between primary short-stem (4.7%) and standard-stem THAs (5.1%).
    • No significant difference in 5-year overall re-revision rates between short-stem (20.9%) and standard-stem THAs (20.4%).

    Conclusions:

    • Short-stem THA may offer a bone-sparing advantage during revision surgery, as standard stems were more commonly used.
    • The overall survivorship (CRR) of short-stem THAs is comparable to standard-stem THAs.
    • Further multinational registry studies are recommended to validate these findings.