ENDOPROTHETICUM : THE ENDO BLOG

Important: In the first 1.5 years after implantation, skeletal scintigraphy often shows false-positive findings due to natural healing and conversion processes. It is only reliably suitable from about 18 months to recognize a real prosthesis loosening or infection.

Recognize prosthesis loosening: causes, symptoms, diagnostics and treatment for loosening hip-tep and loosening knee-tep. Inform now comprehensively!

The modern part of the knee in the focus: the sled prosthesis

Joint replacement: Safe handling of forearm support - learn everything about the correct use of crutches according to the hip prosthesis or knee prosthesis. Tips, techniques and FAQs for more mobility with artificial joint! Read now.

An implant ID documents your endoprosthesis or artificial joint. Find out here why the implant pass for your hip prosthesis or knee prosthesis is so important and what you should consider.

Freedom on horseback while riding despite the hip prosthesis

Do the same rules of conduct be apply to all patients as before?

The innovative rehabilitation according to Hip-Tep and Knie-Tep in Mainz

Why the offset should not be too small and not too big when implanting a hip tep

With hip prosthesis (hip-tep) again on the kiteboard: opportunities and risks

Prevent loosening in endoprostheses: the secret of success of highly networked polyethylene

Meniscus tear: traumatic or degenerative? Find out the causes, symptoms and the best treatment options - from arthroscopy to sled prosthesis!

When does knee arthroscopy still make sense and when should you think about a sled prosthesis or knee prosthesis?

Why will private clinics play a major role in the future for hip prostheses and knee prostheses.

How do you train effectively and safely with a hip prosthesis or knee prosthesis in strength training?

Robots in the implantation of a knee prosthesis (TKA) are developing!

Why the Enlightenment about the process and the risks of a hip prosthesis (Hip-Tep) is so important.

When an outpatient rehab according to the total hip prosthesis (THA) is well suited for you.

The cross-over sign in the X-ray image and the corresponding malposition (retroversion) of the hip is often overlooked!

A suitable indication for a patellofemoral prosthesis (PFJ) is very rare!

How tennis is possible again with a hip prosthesis (THA).

If the UKA prosthesis is no longer sufficient, it is usually possible to switch to a total endoprosthesis (TKA) without any problems!

Stair running after joint replacement: Back to an active life

Hip resurfacing (McMinn) – old idea, new challenges

Why cycling is the perfect choice after hip and knee replacement

Why differentiating between cartilage damage and osteoarthritis is so important.

What to do if the hip replacement hurts?

Why lymphatic drainage is essential after hip and knee replacements

Don't be afraid of swimming after joint replacement!

Advances in Endoprosthetics: Future of Artificial Joint Replacement

Minimally invasive approach to the hip: ALMIS method and short-stem prosthesis

Independent advice in endoprosthetics: the second opinion

The disadvantages of knee sled prostheses: a fact check

The wave is coming! Future forecast of joint replacement operations in Germany

Mild complication after total hip replacement: trochanteric bursitis (bursitis)

Groin pain after hip replacement - what indicates psoas impingement?

PAO or short-shaft prosthesis: which criteria influence the choice 

Kneeling as a challenge after a TKA

Is jogging recommended after total hip replacement? Do short-stem prostheses have any advantages?

Long durability can be expected from modern short-shaft prostheses!

Back and hips: why the pain is similar

Pain is transmitted from the hip to the knee via the iliotibial band

Highly cross-linked polyethylene is the gold standard in hip arthroplasty!

In recent years, the short-shaft prosthesis has established itself as an innovative and bone-friendly alternative to conventional standard shafts. However, as with any hip prosthesis, the shaft may need to be replaced over time. The reasons range from mechanical loosening to infections and material wear. This article highlights the specific advantages of the short-stem prosthesis in the context of a revision and how it can help make the procedure less invasive and more successful. Why is a short-stem prosthesis revised? 1. Mechanical loosening One of the most common causes of socket replacement is loosening of the prosthesis, which can be caused by inadequate osseointegration or abrasion of material particles. 2. Infections Postoperative infections, both acute and chronic, may require replacement of the entire prosthetic system. The removal of the shaft plays a central role here. 3. Periprosthetic fractures Bone fractures in the area of ​​the prosthesis occur primarily in older patients with osteoporotic bone and often require revision. 4. Material wear and osteolysis Modern materials such as ceramics and highly cross-linked polyethylene minimize the risk of material abrasion, but over many years of use, abrasion particles can also cause osteolysis. Advantages of the short-stem prosthesis during a revision 1. Bone preservation Short-stem prostheses are designed to preserve as much femoral bone as possible. This is a crucial advantage if a revision is necessary, as more natural bone is available to anchor the new prosthesis. 2. Ease of removal Due to their shorter length and minimally invasive design, short stem prostheses are often easier to remove than standard stems. This reduces the risk of periprosthetic fractures or bone loss during the procedure. 3. Flexibility in reimplantation After removal of the short-stem prosthesis, several reimplantation options are available, including a short-stem prosthesis again or, in more severe cases, a standard stem. This versatility is particularly advantageous for complex revisions. 4. Protection of the soft tissues Since short-shaft prostheses are usually implanted via minimally invasive approaches, the surrounding muscles and soft tissues are less damaged. This also makes revision easier because there are fewer adhesions or tissue damage. Short-stem prostheses offer some specific advantages if the socket needs to be changed as part of a hip revision. These advantages are due to their unique design and the way they interact with the surrounding bone: 1. Femoral bone preservation The short stem prosthesis requires less bone removal in the proximal femur when initially inserted. This bone preservation becomes an advantage in the event of a socket replacement: the replacement is less invasive because more healthy bone is already present. There is often enough bone remaining to use a standard prosthesis instead of a more complex revision prosthesis. 2. Simplified revision options In contrast to longer stem prostheses, which often require a revision prosthesis with an extended stem during revision, the short stem prosthesis allows a change to a standard prosthesis in many cases. This minimizes: The technical effort of the operation. The risks of complications such as shaft loosening or fractures of the distal femur. 3. Less trauma and faster rehabilitation The replacement of a short-stem prosthesis is usually less traumatic for the patient: the smaller dimension and position of the stem in the proximal femur means fewer surgical challenges. Patients benefit from shorter surgery time, less blood loss and potentially faster post-operative recovery. 4. Flexibility in choosing the new prosthesis Since the short-shaft prosthesis is anchored less deeply in the femur, the distal femur usually remains intact. This offers the surgeon more flexibility in choosing the new prosthesis type and often avoids the need for a modular or extra-long revision prosthesis. 5. Minimizing secondary complications Long-stem prostheses carry a higher risk of complications such as distal femur fractures, particularly in older patients with osteoporosis. This risk is often eliminated with the short-shaft prosthesis because the replacement remains in the upper area of ​​the thigh. The procedure for a revision of short-shaft prostheses 1. Preoperative planning Before the revision, a precise analysis of the bone and the existing prosthesis is carried out using modern imaging techniques such as X-rays, CT and MRI. This helps create the optimal plan for removal and reimplantation. 2. Removal of the old prosthesis Removing the short stem is usually easier and quicker than with standard stems. This is due to the lower anchoring depth and the bone-preserving fixation. 3. Implantation of the new prosthesis Depending on the condition of the bone, a decision is made as to whether a short shaft, a standard shaft or a modular system will be used again. The aim is to achieve the best possible stability and functionality. 4. Postoperative aftercare Rehabilitation focuses on restoring mobility and muscle strength. Patients with short-stem prostheses often benefit from faster recovery. Studies on the revision of short-stem prostheses Modern studies show that short-stem prostheses not only cause less bone loss during revisions, but also offer a similarly high success rate as standard shafts. Young patients in particular benefit from the bone-sparing strategy, as they may need multiple changes throughout their lives. Some studies also emphasize that short stems can achieve similar mechanical stability to long stems during revisions, provided the bone status allows this. Critical consideration: When is the short-shaft prosthesis not suitable? Despite the many advantages, there are situations in which short-stem prostheses are not ideal for revisions: Severe osteolysis: If the bone is severely damaged, a long-stem prosthesis often offers better stability. Periprosthetic fractures: Here a long shaft is required to adequately support the bone. Chronic infections: For extensive infections, modular or long stem systems may be a better choice. Are short-stem prostheses the future of revision? The short-stem prosthesis offers numerous advantages in the context of socket changes, especially with regard to bone protection and simpler revision procedures. It is particularly suitable for younger, active patients who may require further revisions throughout their lives. However, their use requires careful preoperative planning and is not suitable in all cases. With further advances in prosthesis technology and more long-term studies, short-stem prostheses could play an even greater role in revision surgery in the future. Conclusion: Do short-stem prostheses make socket replacement easier? Short-shaft prostheses offer significant advantages in the context of a socket change, not only through bone preservation, but also through the flexibility in choosing the revision strategy. The ability to frequently use a standard prosthesis and the lower burden on the patient make short-stem prostheses a superior option in modern endoprosthetics.