{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:29:49Z","timestamp":1791293389970,"version":"4.1.0"},"reference-count":101,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":2844,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Over the last two decades, several conservative femoral prostheses have been designed. The goals of conservative stems include: the spearing of the trochanteric bone stock; a more physiological loading in the proximal femur reducing the risk of stress shielding; and to avoid a long stem into the diaphysis preventing impingement with the femoral cortex and thigh pain. All stems designed to be less invasive than conventional uncemented stems are commonly named \u2018short stems\u2019. However, this term is misleading because it refers to a heterogeneous group of stems deeply different in terms of design, biomechanics and bearing. In the short-term follow-up, all conservative stems provided excellent survivorship. However, variable rates of complications were reported, including stem malalignment, incorrect stem sizing and intra-operative fracture. Radiostereometric analysis (RSA) studies demonstrated that some conservative stems were affected by an early slight migration and rotation within the first months after surgery, followed by a secondary stable fixation. Dual-energy x-ray absorptiometry (DEXA) studies demonstrated an implant-specific pattern of bone remodelling. Although the vast majority of stems demonstrated a good osseointegration, some prostheses transferred loads particularly to the lateral and distal-medial regions, favouring proximal stress shielding and bone atrophy in the great trochanter and calcar regions.<\/jats:p>\n                  <jats:p>Cite this article: EFORT Open Rev 2018;3:149-159. DOI: 10.1302\/2058-5241.3.170052<\/jats:p>","DOI":"10.1302\/2058-5241.3.170052","type":"journal-article","created":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T07:04:54Z","timestamp":1525849494000},"page":"149-159","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-16","source":"Crossref","is-referenced-by-count":67,"title":["Uncemented short stems in primary total hip arthroplasty: The state of the art"],"prefix":"10.1530","volume":"3","author":[{"given":"Mattia","family":"Loppini","sequence":"first","affiliation":[{"name":"1Department of Biomedical Sciences, Humanitas University, Italy; Hip Diseases and Joint Replacement Surgery Unit, Humanitas Clinical and Research Center, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Grappiolo","sequence":"additional","affiliation":[{"name":"2Hip Diseases and Joint Replacement Surgery Unit, Humanitas Clinical and Research Center, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2018,5,9]]},"reference":[{"key":"2026070711215346100_bibr1-2058-5241.3.170052","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3928\/01477447-20090728-07","article-title":"Cemented femoral fixation: the North Atlantic divide","volume":"32","author":"Dunbar","year":"2009","journal-title":"Orthopedics"},{"key":"2026070711215346100_bibr2-2058-5241.3.170052","volume-title":"Annual Report","author":"Australian Orthopaedic Association National Joint Replacement Registry","year":"2014"},{"key":"2026070711215346100_bibr3-2058-5241.3.170052","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1080\/17453670710013861","article-title":"Comparison of cemented and uncemented fixation in total hip replacement: a meta-analysis","volume":"78","author":"Morshed","year":"2007","journal-title":"Acta Orthop"},{"key":"2026070711215346100_bibr4-2058-5241.3.170052","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1007\/s11999-013-2941-7","article-title":"A review of current fixation use and registry outcomes in total hip arthroplasty: the uncemented paradox","volume":"471","author":"Troelsen","year":"2013","journal-title":"Clin Orthop Relat Res"},{"key":"2026070711215346100_bibr5-2058-5241.3.170052","first-page":"144","article-title":"The CLS system. 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