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Updated: Jul 15, 2026
07:05
Use of Human Perivascular Stem Cells for Bone Regeneration
Published on: May 25, 2012
22.0K
Short-stem-ology: personal 25-year experience with short stems
Filippo Casella1, Gianluca Mazzotta1, Fabio Favetti2
1San Filippo Neri Hospital, Orthopaedic Division, Rome, Italy.
EFORT Open Reviews
|November 12, 2025
Summary
Orthopaedic surgeons remain skeptical of short stems despite excellent survival rates and acceptable risks. These implants, used in up to 50% of hip replacements, offer bone preservation benefits but require careful revision strategies.
Area of Science:
- Orthopaedic surgery
- Biomaterials science
Background:
- Short stems are increasingly utilized in total hip replacements, accounting for up to 50% of procedures in some centers.
- Despite initial skepticism among orthopaedic surgeons, registry data show excellent survival rates and acceptable complication risks for short stems.
Purpose of the Study:
- To evaluate the clinical outcomes, survivorship, and revision strategies associated with short stem implants in total hip arthroplasty.
- To address the persistent skepticism regarding short stems by analyzing their long-term performance and bone preservation benefits.
Main Methods:
- Retrospective analysis of clinical data and international registry reports on short stem hip implants.
- Evaluation of complications, survivorship, and revision procedures, including two-stage revisions for periprosthetic joint infection (PJI) and stem revisions for periprosthetic fractures.
Main Results:
- Short stems demonstrate very good clinical results and survivorship, even with widened indications related to patient age and pathology.
- Bone preservation is a key benefit, though potential limitations and weak points have been identified in evolving designs.
- Failure modes are primarily linked to bone preservation strategies during revision surgery.
Conclusions:
- Short stems offer comparable outcomes to traditional primary hip implants, challenging surgeon skepticism.
- Effective revision strategies are crucial for managing short stem failures, particularly concerning bone stock preservation.
- Continued research and design evolution are important for optimizing short stem performance and addressing identified limitations.
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