Clinical-functional mid-term outcomes with a short femoral stem. Is this really a good option in young patients?

Introduction: There has been an increase in the use of “short stems” with the increase in the incidence of Total Hip Arthroplasty (THA) in young patients. Objectives To analyse the clinical-functional results at mid-term in patients undergoing THA with a short stem. Materials and Method A retrospective study on 117 patients (127 hips) undergoing a THA intervention using a short stem with follow-up at least for one year. Functional results were analysed through modified Harris Hip Score (mHHS) and Tegner Activity Scale (TAS), before and after the surgical procedure. Moreover, the time until reincorporation to work was analysed, as well as the alignment of the stem regarding the anatomical femoral axis, and any post-operatory complications. Patient satisfaction was assessed through survey by telephone at the end of follow-up. “Short stem” survival was calculated with Kaplan-Meier analysis. Results The mean follow-up was 5.4 (range, 1-10.2) years; 81.1% of patients undergoing the procedure were male, and the mean age was 50.9 (range, 20–73) years. The main cause for intervention was primary coxarthrosis (60.7%). The mean time until reincorporation to work was 5.8 (range, 1–14) months and 4.9 (range, 2–12) months to resume a satisfactory sports level. There was an improvement in clinical-functional results during the first year versus pre-surgical values (mHHS: +57.1; p < 0.001, TAS + 1.2; p < 0.001). An 86.5% of participants in the survey stated at the end of follow-up that they were very satisfied with their surgical procedure. The radiological analysis showed a neutral alignment of the stem in 98.4% of cases. No complications were present in 83.5% of patients; the survival rate at 3, 5 and 7 years was 99.2% (CI 95%, 0.94% − 0.99%). Conclusion Short stems showed excellent clinical-functional outcomes, with optimal sporting recovery, and survival at mid-term comparable with the best results offered by conventional stems.