Short Stems in Total Hip Replacement: Current Status and Future

Short stem hip implants have been introduced as a bone preserving surgery for younger and more active people undergoing hip arthroplasty. Although many short stems are now available, clinical results and long-term survival are controversial. The aim of this paper is to describe the features of the short stems and to analyse their clinical results and long-term survival. The short-stem implants reproduce a stress distribution at the level of the proximal femur more similar to the physiological femur limiting the stress-shielding that occur with conventional cementless stems. Though short stems are an alternative to conventional stems, their use is not yet justified despite the promising short and mid-term survival results. Higher incidence of complications, such as periprosthetic fractures and malpositioning of the stem, and the lack of long-term results do not allow to predict what role in the future short stems in total hip replacement may have.