MID-TERM CLINICAL AND RADIOLOGICAL OUTCOMES OF SHORT-STEM VERSUS CONVENTIONAL-STEM TOTAL HIP ARTHROPLASTY IN PATIENTS...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Total hip arthroplasty (THA) in young patients with osteonecrosis of the femoral head (ONFH) presents challenges in bone preservation and implant longevity.
• Short femoral stems are increasingly used for their bone-conserving design, but evidence in ONFH is limited.

Purpose of the Study:

• To compare the mid-term clinical and radiographic outcomes of short femoral stems versus conventional stems in primary cementless THA for ONFH.
• To evaluate the bone-preserving potential and implant longevity of short stems in this specific patient group.

Main Methods:

• A prospective case-control study involving 108 patients with ONFH undergoing primary cementless THA.
• Patients received either a metaphyseal-fitting short femoral stem (n=27) or a conventional length stem (n=81).
• Clinical outcomes (Harris Hip Score, Roles and Maudsley score) and radiographic parameters (fixation, subsidence, radiolucency) were assessed at a mean 4.2-year follow-up.

Main Results:

• Both short and conventional stems demonstrated excellent clinical improvement, with high postoperative Harris Hip Scores (91 vs. 92).
• Complete osseointegration was observed, with no significant differences in periprosthetic osteolysis, femoral radiolucency, or cup loosening.
• Minor, asymptomatic subsidence occurred in a small number of cases in both groups, with no significant differences in complication rates or hospital stay.

Conclusions:

• Short femoral stems provide comparable mid-term clinical and radiographic outcomes to standard stems in young patients with ONFH.
• Short stems are a reliable, bone-preserving option for total hip arthroplasty in this population, supporting their continued use.