{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T12:48:01Z","timestamp":1791722881428,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T00:00:00Z","timestamp":1705795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Cementless primary stems in revision hip arthroplasties may be conservative options to preserve bone stock and provide adequate reconstruction of the hip biomechanics. However, there is still little evidence about indications, limitations, and outcomes. This narrative review showed that conventional standard stems were adopted in different revision settings, up to Paprosky IIIA grade bone defects. In cases of acceptable metaphyseal bone stock, when a scratch fit of at least 4 cm can be achieved, a conventional cementless stem may be an adequate solution. Mid-term clinical and radiographic outcomes and survival rates were similar to long revision stems, whereas complications, surgical time, and costs were lower among conventional stems. However, unsuitable contexts for conventional stems included canal diameters larger than 18 mm and failed revision stems with cortical weakening. Even short stems can be considered in revisions, in order to preserve bone stock and stay proximal to femoral remodeling zones and bone\/cement plugs. Short stems were successfully adopted up to Paprosky IIIA bone defects, achieving mid-term survival rates not inferior to long revision stems. Ageing, osteoporosis, and intraoperative femoral fractures were the main negative prognostic factors. In very select cases, a downsizing technique (from longer to shorter stems) may be adopted to simplify the procedure and reduce complications.<\/jats:p>","DOI":"10.3390\/jcm13020604","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T11:36:41Z","timestamp":1705923401000},"page":"604","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cementless Primary Stems in Revision Hip Arthroplasty: A Narrative Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3567-9194","authenticated-orcid":false,"given":"Francesco","family":"Castagnini","sequence":"first","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pardo","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4264-3827","authenticated-orcid":false,"given":"Stefano","family":"Lucchini","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Rotini","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Cavalieri","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Dalla Rosa","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Vitacca","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0716-4951","authenticated-orcid":false,"given":"Alberto","family":"Di Martino","sequence":"additional","affiliation":[{"name":"1<sup>st<\/sup> Orthopedics and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences\u2014DIBINEM, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Faldini","sequence":"additional","affiliation":[{"name":"1<sup>st<\/sup> Orthopedics and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences\u2014DIBINEM, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-101X","authenticated-orcid":false,"given":"Francesco","family":"Traina","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti d\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136 Bologna, Italy"},{"name":"Department of Biomedical and Neuromotor Sciences\u2014DIBINEM, University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e072462","DOI":"10.1136\/bmjopen-2023-072462","article-title":"Epidemiology of revision hip replacement surgery in the UK over the past 15 years-an analysis from the National Joint Registry","volume":"13","author":"Sabah","year":"2023","journal-title":"BMJ Open"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Longo, U.G., Papalia, R., Salvatore, G., Tecce, S.M., Jedrzejczak, A., Marcozzi, M., Piergentili, I., and Denaro, V. 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