{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T12:48:04Z","timestamp":1791722884367,"version":"4.3.4"},"reference-count":42,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Implantation of a short femoral stem in revision total hip arthroplasty (rTHA) could reduce the perioperative time, soft tissue damage, and preserve the bone stock of the proximal femur. The objective of this study was to describe the clinical and radiographic outcomes after the use of short stems in rTHA with a follow-up of 1 to 5 years. Materials and Methods: This retrospective, single center, and observational study analyzed the data of 31 patients (12 female, 19 male) with a median (interquartile range) age of 68.2 years (61.2\u201378.4) and BMI of 26.7 kg\/m2 (24.6\u201329.4) who received an uncemented short femoral stem in rTHA between 2015 and 2020. Clinical outcomes were extracted from medical reports and assessed using the modified Harris Hip Score (mHHS), the numerical rating scale (NRS) for pain and satisfaction, and the UCLA Physical Activity Score. Radiographs were analyzed for stem subsidence, fixation, and bone parameters. The Wilcoxon test was used for pre\u2013post rTHA differences (p &lt; 0.05); clinical relevance was interpreted based on effect sizes according to Cohen\u2019s d. Results: All the clinical outcome measures improved significantly (p \u2264 0.001) at follow-up compared to preoperative status, with large effect sizes (Cohen\u2019s d) ranging from 2.8 to 1.7. At the last follow-up, the median (interquartile) mHHS was 80.9 (58.6\u201393.5). Stem fixation was stable in all cases. Complications included stem subsidence of 3 mm (n = 1) and 10 mm (n = 1), heterotopic ossification Brooker stage III (n = 2), intraoperative femur perforation (n = 1), periprosthetic fracture Vancouver type A (n = 1), and dislocation (n = 2). Conclusions: The good clinical results in our selective study population of patients with mild to moderate bone deficiency, supported by large effect sizes, together with a complication rate within the normal range, support the consideration of short stems as a surgical option after a thorough preoperative analysis.<\/jats:p>","DOI":"10.3390\/medicina59101822","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T06:07:26Z","timestamp":1697177246000},"page":"1822","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Use of Short Stems in Revision Total Hip Arthroplasty: A Retrospective Observational Study of 31 Patients"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9576-1222","authenticated-orcid":false,"given":"Marlene","family":"Mauch","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, University Hospital Basel, 4031 Basel, Switzerland"},{"name":"Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Brecht","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Clauss","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University Hospital Basel, 4031 Basel, Switzerland"},{"name":"Center for Musculoskeletal Infections (ZMSI), University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4431-3626","authenticated-orcid":false,"given":"Karl","family":"Stoffel","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1007\/s00132-021-04083-y","article-title":"Short versus conventional stem in cementless total hip arthroplasty: An evidence-based approach with registry data of mid-term survival","volume":"50","author":"Steinbruck","year":"2021","journal-title":"Orthopade"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.jocd.2013.11.001","article-title":"Osseointegration of Fitmore stem in total hip arthroplasty","volume":"17","author":"Gasbarra","year":"2014","journal-title":"J. Clin. Densitom."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/j.arth.2010.10.001","article-title":"Comparison of bone mineral density changes around short, metaphyseal-fitting, and conventional cementless anatomical femoral components","volume":"26","author":"Kim","year":"2011","journal-title":"J. Arthroplasty"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1016\/j.arth.2018.01.005","article-title":"Short Stems Versus Conventional Stems in Cementless Total Hip Arthroplasty: A Long-Term Registry Study","volume":"33","author":"Giardina","year":"2018","journal-title":"J. Arthroplasty"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.arth.2014.01.003","article-title":"Short stem metaphyseal-engaging femoral implants: A case-controlled radiographic and clinical evaluation with eight year follow-up","volume":"30","author":"Chow","year":"2015","journal-title":"J. Arthroplasty"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e301","DOI":"10.3928\/01477447-20130222-18","article-title":"Stable, dependable fixation of short-stem femoral implants at 5 years","volume":"36","author":"Patel","year":"2013","journal-title":"Orthopedics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"700","DOI":"10.3928\/01477447-20130821-06","article-title":"Outcomes of short stems in total hip arthroplasty","volume":"36","author":"Banerjee","year":"2013","journal-title":"Orthopedics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.2106\/JBJS.M.00780","article-title":"Short bone-conserving stems in cementless hip arthroplasty","volume":"96","author":"Khanuja","year":"2014","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.clinbiomech.2017.12.004","article-title":"No effect of conventional vs. minimally invasive surgical approach on clinical outcome and migration of a short stem total hip prosthesis at 2-year follow-up: A randomized controlled study","volume":"51","author":"Schwarze","year":"2018","journal-title":"Clin. Biomech."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2606","DOI":"10.1007\/s11999-009-0834-6","article-title":"Future young patient demand for primary and revision joint replacement: National projections from 2010 to 2030","volume":"467","author":"Kurtz","year":"2009","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1007\/s00590-021-02881-w","article-title":"Revision rate of THA in patients younger than 40 years depends on primary diagnosis\u2014A retrospective analysis with a minimum follow-up of 10 years","volume":"31","author":"Rahm","year":"2021","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_12","unstructured":"Australian Orthopaedic Association National Joint Replacement Registry (2022, February 15). Annual Report (Hip, Knee & Shoulder Annual Report). Available online: https:\/\/aoanjrr.sahmri.com\/annual-reports-2022."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e4751","DOI":"10.1097\/MD.0000000000004751","article-title":"Clinical characteristics and risk factors of periprosthetic femoral fractures associated with hip arthroplasty: A retrospective study","volume":"95","author":"Zhang","year":"2016","journal-title":"Medicine"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S171","DOI":"10.1016\/j.otsr.2014.07.031","article-title":"Selecting the surgical approach for revision total hip arthroplasty","volume":"101","author":"Kerboull","year":"2015","journal-title":"Orthop. Traumatol. Surg. Res."},{"key":"ref_15","first-page":"1","article-title":"Femoral revision with primary cementless stems: A systematic review of the literature","volume":"102","author":"Cavagnaro","year":"2018","journal-title":"Musculoskelet. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s00590-016-1749-z","article-title":"Extended trochanteric osteotomy: Current concepts review","volume":"26","author":"Sambandam","year":"2016","journal-title":"Eur. J. Orthop. Surg. Traumatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1097\/00003086-200403000-00021","article-title":"The use of tapered stems for femoral revision surgery","volume":"420","author":"Bohm","year":"2004","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_18","first-page":"403","article-title":"Technical considerations and functional results in primary uncemented hip arthroplasty using short femoral stems through mini-invasive techniques","volume":"7","author":"Moga","year":"2014","journal-title":"J. Med. Life"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"528","DOI":"10.5312\/wjo.v11.i11.528","article-title":"Use of short stems in revision of standard femoral stem: A case report","volume":"11","author":"Evola","year":"2020","journal-title":"World J. Orthop."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.2106\/JBJS.CC.16.00174","article-title":"A Short Femoral Stem in Revision Total Hip Replacement: An Alternative Solution for Prosthetic Fracture: A Case Report","volume":"7","author":"Lee","year":"2017","journal-title":"JBJS Case Connect"},{"key":"ref_21","first-page":"1168.e13","article-title":"Revision hip arthroplasty with a short femoral component in fractured hydroxyapatite fully coated femoral stem","volume":"25","author":"Soriano","year":"2010","journal-title":"J. Arthroplasty"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jcot.2020.09.033","article-title":"Role of a bone conserving short stem femoral component in revision total hip arthroplasty: A case report","volume":"14","author":"Thorat","year":"2021","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Valle, C.J., and Paprosky, W.G. (2003). Classification and an algorithmic approach to the reconstruction of femoral deficiency in revision total hip arthroplasty. J. Bone Joint Surg. Am., 85-A.","DOI":"10.2106\/00004623-200300004-00001"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jcrc.2004.09.007","article-title":"A systematic review of the Charlson comorbidity index using Canadian administrative databases: A perspective on risk adjustment in critical care research","volume":"20","author":"Needham","year":"2005","journal-title":"J. Crit. Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1053\/jars.2000.7683","article-title":"Prospective analysis of hip arthroscopy with 2-year follow-up","volume":"16","author":"Byrd","year":"2000","journal-title":"Arthroscopy"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1177\/0363546513494173","article-title":"Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery","volume":"41","author":"Kemp","year":"2013","journal-title":"Am. J. Sports Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1111\/j.1365-2702.2005.01121.x","article-title":"Pain: A review of three commonly used pain rating scales","volume":"14","author":"Williamson","year":"2005","journal-title":"J. Clin. Nurs."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1080\/17453674.2021.1977533","article-title":"Measurement properties of UCLA Activity Scale for hip and knee arthroplasty patients and translation and cultural adaptation into Danish","volume":"92","author":"Skou","year":"2021","journal-title":"Acta Orthop."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/S0883-5403(98)90195-4","article-title":"Assessing activity in joint replacement patients","volume":"13","author":"Zahiri","year":"1998","journal-title":"J. Arthroplasty"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"737","DOI":"10.2106\/00004623-196951040-00012","article-title":"Traumatic arthritis of the hip after dislocation and acetabular fractures: Treatment by mold arthroplasty. An end-result study using a new method of result evaluation","volume":"51","author":"Harris","year":"1969","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1007\/s11999-016-5012-z","article-title":"Classifications In Brief: The Paprosky Classification of Femoral Bone Loss","volume":"475","author":"Ibrahim","year":"2017","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1302\/0301-620X.93B10.25927","article-title":"Femoral revision with the Wagner tapered stem: A ten- to 15-year follow-up study","volume":"93","author":"Regis","year":"2011","journal-title":"J. Bone Joint Surg. Br."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1302\/0301-620X.96B4.32607","article-title":"Performance of the CLS Spotorno uncemented stem in the third decade after implantation","volume":"96-B","author":"Evola","year":"2014","journal-title":"Bone Joint J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.arth.2014.12.024","article-title":"Femoral Revision Using the Wagner SL Revision Stem: A Single-Surgeon Experience Featuring 11-19 Years of Follow-Up","volume":"30","author":"Baktir","year":"2015","journal-title":"J. Arthroplasty"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/BLO.0b013e3180986170","article-title":"A modified transfemoral approach using modular cementless revision stems","volume":"462","author":"Fink","year":"2007","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.2106\/00004623-197355080-00006","article-title":"Ectopic ossification following total hip replacement. Incidence and a method of classification","volume":"55","author":"Brooker","year":"1973","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/S0883-5403(97)90136-4","article-title":"Outcome after total hip arthroplasty. Comparison of a traditional disease-specific and a quality-of-life measurement of outcome","volume":"12","author":"Lieberman","year":"1997","journal-title":"J. Arthroplasty"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/00003086-200103000-00022","article-title":"Is the Harris hip score system useful to study the outcome of total hip replacement?","volume":"384","author":"Soderman","year":"2001","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1037\/0033-2909.112.1.155","article-title":"A power primer","volume":"112","author":"Cohen","year":"1992","journal-title":"Psychol. Bull."},{"key":"ref_40","unstructured":"Lenhard, W., and Lenhard, A. (2023, June 10). Computation of Effect Sizes. Available online: https:\/\/www.psychometrica.de\/effect_size.html."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2309499019854156","DOI":"10.1177\/2309499019854156","article-title":"Long-term outcomes of Wagner self-locking stem with bone allograft for Paprosky type II and III bone defects in revision total hip arthroplasty: A mean 15.7-year follow-up","volume":"27","author":"Zang","year":"2019","journal-title":"J. Orthop. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Liu, Z., Liu, B., Zhang, B., Ma, W., Wu, T., Huo, J., Liu, S., and Han, Y. (2021). Short uncemented femoral component for hip revision: Prognosis and risk factors associated with failure. BMC Surg., 21.","DOI":"10.1186\/s12893-021-01196-1"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/10\/1822\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:06:10Z","timestamp":1760130370000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/10\/1822"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,13]]},"references-count":42,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["medicina59101822"],"URL":"https:\/\/doi.org\/10.3390\/medicina59101822","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,13]]}}}