Choosing the right prosthesis is one of the most important decisions for both patients and surgeons during hip replacement surgery. In recent years, the short stem prosthesis established itself as a modern alternative to conventional straight stems. Its innovative design offers numerous advantages, particularly regarding bone preservation, natural force transmission, and faster rehabilitation.

In this comprehensive article, we discuss the advantages of short stems and compare them to traditional straight stems. We also examine which patients this technique is particularly suitable for and why it is shaping the future of endoprosthetics.

Anatomy of the hip and the need for joint replacement

The human hip joint is one of the most stressed joints in the body. It consists of the femoral head (head of the femur) and the acetabulum (socket), which are protected by a stable joint capsule and a complex muscle structure.

However, with increasing age or due to certain conditions such as osteoarthritis, the joint can wear down, leading to severe pain and restricted movement. In such cases, a hip replacement may be necessary to improve the patient's quality of life.

What is a short shaft for the hip?

A short stem is a special type of hip prosthesis that is shorter and rounder compared to conventional straight stems and allows for bone-saving anchoring in the thigh bone (femur).

Special features of a short shaft:

• Shortened shaft length : In contrast to traditional straight shafts, the short shaft is significantly shorter, which facilitates minimally invasive implantation.
• Bone-saving design : The bone is protected, which is particularly beneficial for younger patients who may need a revision in the future.
• Anatomical adaptation : The shape of the short shaft adapts to the natural anatomy of the femur and ensures optimal power transmission.
• Stable anchorage : Despite its shorter length, the short stem ensures stable fixation in the bone, often through cementless implantation.

Advantages of short shafts compared to conventional straight shafts

1. Bone preservation and improved revision options

One of the biggest advantages of the short stem is the significant bone preservation . Because less bone material needs to be removed, more of the patient's own bone substance is retained. This is particularly important should revision surgery become necessary in the future.

2. Minimally invasive surgical technique

The reduced stem design allows for minimally invasive implantation . This means:

• Minor skin incisions
• Less tissue trauma
• Faster wound healing
• Reduced postoperative pain
• Faster mobilization

3. Physiological force transmission

The short shaft allows for a more natural distribution of forces in the femur, thereby reducing the risk of bone loss due to "stress shielding".

4. Faster rehabilitation

Patients with a short-stem prosthesis benefit from faster rehabilitation . Studies show that they are often mobile again sooner and can resume everyday activities more quickly.

Comparison: Short shaft vs. straight shaft

The short stem offers a high degree of bone preservation, while the straight stem involves a greater amount of bone resection. The minimally invasive surgical technique used with the short stem allows for smaller skin incisions and less tissue trauma compared to the straight stem. In terms of load-bearing capacity, both stem types are equivalent; however, revision surgery is simpler with the short stem because more bone is preserved. The healing time is also usually shorter with the short stem, allowing patients to return to their daily activities more quickly. Furthermore, soft tissue preservation is significantly greater with the short stem than with conventional straight stems.

Which patients benefit most from short stem implants?

Not every patient is suitable for a short stem prosthesis. However, those who particularly benefit are:

• Younger patients who may need a revision in the future
• Active people who desire a rapid rehabilitation
• Patients with good bone quality , as the short stem requires solid anchorage in the bone.

Conclusion: Short shafts for the hip are becoming the norm!

The short stem represents a modern, bone-conserving, and gentle alternative to traditional straight stems. Thanks to minimally invasive surgical techniques, improved power transmission, and faster rehabilitation, it offers numerous advantages for many patients.

Anyone interested in a hip replacement should definitely seek advice from an experienced hip specialist to find the optimal solution for their individual needs.