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19.03.2020 | Review Article

Short stems for total hip replacement among middle-aged patients

International Orthopaedics
Filippo Migliorini, Arne Driessen, Giorgia Colarossi, Yasser El Mansy, Matthias Gatz, Markus Tingart, Jörg Eschweiler
Wichtige Hinweise
Level of Evidence: II, meta-analysis of clinical trials.

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The purpose of the present study was to investigate the role of short stem implants for primary total hip arthroplasty in middle-aged patients. For this purpose, a meta-analysis of the current literature was conducted. The focus was on clinical outcomes,radiological parameters, and further complications of both components.

Material and methods

The study was performed according to the PRISMA guidelines. All randomized and non-randomized clinical trials comparing short stem versus standard stem prostheses for THA were considered for inclusion. Only studies reporting data concerning uncemented stems for primary total hip arthroplasty were included. Only studies reporting data concerning patients with a mean age of 45 to 69 were included.


A total of 2197 procedures in 2116 patients were analysed. The mean follow-up was 30.2 months. The short stem group showed a statistically significant higher WOMAC score and a reduced total estimated blood loss compared with the standard stem group. The short stem group showed a reduced rate of femoral fractures, dislocations, and revision, but without statistical significance.


According to the main findings of this meta-analysis and current evidence, we encourage the use of the uncemented short stems during primary total hip arthroplasty in middle-aged patients.

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