1️⃣ What is a short stem hip prosthesis and how does it differ from a standard hip prosthesis?

A short stem prosthesis is a modern form of artificial hip joint that preserves the natural bone structure as much as possible. Unlike classical hip prostheses, only the upper part of the femur is replaced in the short stem variant - the so-called femoral neck is partially preserved. This preserves more of the patient's own bone, which is a significant advantage, especially for younger or active patients.
Short stem prostheses are usually implanted without cement and grow biologically into the bone. The anatomically adapted shape creates a very natural feeling of movement. Many patients report that they can stand and walk safely again shortly after the operation.
Modern short stem systems such as Metha®, Fitmore®, or Optimys® have been clinically tested for many years and are considered just as reliable as conventional prostheses - but more bone-preserving.

2️⃣ Why do doctors or patients choose a short stem hip prosthesis instead of a standard prosthesis?

The most important reason is the preservation of valuable bone substance. With a short stem prosthesis, less bone needs to be removed, which is particularly crucial for younger or physically active individuals. If a revision is necessary later, sufficient stable bone structures are still available.
Additionally, the shorter stem length offers biomechanical advantages: the force transmission more closely resembles the natural movement sequence, which many patients find more comfortable. Furthermore, short stem prostheses can often be implanted via minimally invasive approaches – resulting in smaller incisions, less blood loss, and faster recovery.
In experienced hands, such as those of specialists like Prof. Dr. Karl Philipp Kutzner at Endoprotheticum Rhein-Main, this technique can achieve excellent results – both functionally and cosmetically.

3️⃣ How is the short stem prosthesis anchored in the bone?

Short-stem prostheses are usually anchored without cement. This means that the surgeon precisely places the stem in the upper part of the femur, where it fits perfectly. The rough titanium surface is usually microporous coated, allowing the body's own bone tissue to grow directly into it.
After a few weeks, the implant is biologically firmly integrated – similar to a natural connection between bone and prosthesis. This physiological load transfer continues to stimulate the bone, preventing bone loss.
This cement-free approach is considered particularly durable and enables a later prosthesis replacement with relatively little effort if needed. However, it is crucial that the exact placement and selection of the prosthesis model are performed by an experienced hip specialist.

4️⃣ Is the short-stem prosthesis a “new” or proven method?

The short stem prosthesis is a modern development, but by no means an experiment. The first concepts emerged as early as the 1980s, but the decisive progress came with titanium alloys and new coatings from the 2000s onwards.
Today, the best-known short stem systems have long-term results over 10 to 15 years available – with survival rates of over 95%. This makes them just as durable as standard prostheses, when correctly indicated and implanted.
Especially in specialized centers like the Endoprotheticum Rhein-Main the technique is used routinely. Short stem prostheses have established themselves here as a proven, safe, and future-oriented alternative , especially for patients who value bone preservation, mobility, and natural function.

5️⃣ Who is a short-stem prosthesis particularly suitable for?

Short-stem prostheses are particularly suitable for people who are active, young, or remain youthful and have good bone quality. They are commonly used in patients between the ages of 40 and 70 whose hip joint is damaged due to osteoarthritis, malalignment, or wear.
Even physically active individuals benefit from this type of implant, as it preserves natural mobility. The prerequisite is that the upper part of the femoral bone (metaphysis) is stable, allowing the implant to be securely anchored.
However, short-stem prostheses are not suitable for cases with severe bone loss (osteoporosis) or complex malalignments. In all other cases, they offer an excellent option for durable, bone-preserving, and functional hip care.

6️⃣ Can older people also receive a short-stem hip replacement?

Yes, this is generally possible – however, it depends on the bone quality. If the femoral bone is stable enough, a short-stem prosthesis can also be useful for older patients.
The advantage is that less bone is removed and the intervention is therefore gentler . In addition, rehabilitation can progress faster because the musculature is often better preserved.
An individual assessment by an experienced surgeon is important: age alone is not an exclusion criterion; bone density, general condition and desire for mobility are decisive. Many patients over 70 also benefit from the technique – provided it is used in the right setting.

7️⃣ When is a short stem prosthesis not advisable?

A short stem prosthesis is less suitable if the bone structure in the upper thigh is severely damaged, for example due to osteoporosis, previous fractures or large cysts. Also, in cases of severe anatomical deformities or after certain previous surgeries (e.g. after osteotomies), the hold of a short stem may be insufficient.
In such cases, a standard prosthesis with longer stem anchoring is usually used to ensure maximum stability.
Therefore, individual planning using X-ray or 3D imaging is crucial. An experienced orthopedic surgeon can determine when a short stem prosthesis is optimal – and when other solutions are safer.

8️⃣ Is the short-stem prosthesis also suitable for physically active individuals?

Yes – especially for physically active people, the short-stem hip replacement is often an excellent choice.
Due to the anatomically adapted shape and bone-preserving fixation the natural force transmission in the thigh is largely preserved. This results in a very harmonious sensation of movement.
Many patients report that just a few weeks after surgery, they are able to cycle, hike or swim again. Sports with a low impact or jumping component are also usually possible without any problems.
The prerequisite is good bone quality and professional implantation by an experienced surgeon. Specialists like Prof. Dr. Karl Philipp Kutzner at Endoprotheticum Rhein-Main provide individual advice on which activities are possible again after surgery.

9️⃣ What materials are used in short stem prostheses?

Modern short-stem prostheses are almost always made of high-purity titanium or titanium alloys.
Titanium is lightweight, stable, highly compatible, and provides excellent conditions for bone ingrowth. The bearing pair – i.e., what forms the femoral head and cup – is usually made of ceramic-ceramic or ceramic-polyethylene.
This combination minimizes friction and wear, ensuring extremely smooth movement.
Additionally, titanium alloys are corrosion-resistant and biologically inert – the body does not recognize them as foreign material.
The result: long durability, excellent biocompatibility, and optimal mobility.

What does 'cement-free' mean in the context of a short-stem hip replacement?

'Cement-free' means that the prosthesis is not fixed with bone cement, but is inserted directly into the bone.
The surface of the stem is specially coated (usually with titanium or hydroxylapatite structures), allowing the bone tissue to grow into the implant surface.
This biological integration makes the connection particularly stable and durable.
Another advantage: If a replacement is needed in 20 or 30 years, a cement-free implant can be removed much more easily, without losing much bone.
Cement-free short-stem prostheses are now the gold standard for younger and active patients.

1️⃣1️⃣ How is it ensured that the short-stem prosthesis is securely seated in the bone?

The stability of the prosthesis is achieved through a combination of precise fit, optimal size, and biological ingrowth.
Before surgery, the bone is measured with millimeter accuracy – often using 3D planning or digital X-ray analysis.
During the procedure, the shaft is then precisely inserted into the prepared bone until it is securely seated.
In the first few weeks after surgery, the bone grows directly into the titanium surface.
After about six to eight weeks, the connection is biologically stable.
This combination of mechanics and biology ensures that the short-stem prosthesis is permanently firmly anchored and provides a very natural feeling of walking.

1️⃣2️⃣ What are the differences between various short stem models (e.g. Metha®, Fitmore®, Optimys®)?

There are various short stem systems that differ slightly in shape, length, and anchoring principle:

• Metha® shaft: proven classic with anatomically curved shape, particularly suitable for standardized bone conditions.
• Fitmore® shaft: has a rather straight shape, which allows a very stable metaphyseal anchorage.
• Optimys®-Shaft: combines short design with physiological force transmission – ideal for young, active people.
  They all share the goal of preserving bone, sparing muscle, and allowing natural stress.
  The selection is always individual – depending on bone shape, age, activity level, and surgeon experience.
• Prof. Dr. med. Karl Philipp Kutzner is a renowned expert for the Optimys®-stem.

1️⃣3️⃣ How is the surgery for a short-stem prosthesis performed?

The surgery is performed under general or partial anesthesia and usually takes between 60 and 90 minutes.
Through a small, muscle-sparing approach, the femoral head is removed and the femur is prepared so that the short stem can be precisely inserted.
The femoral head and cup are then fitted with the new bearing surface.
Because the procedure is minimally invasive, muscles and tendons are largely spared – resulting in less pain and faster recovery.
As early as the first day after surgery, patients can stand up and walk under physiotherapeutic guidance.

1️⃣4️⃣ How long does the surgery take and how long do I stay in the hospital?

The actual surgery time is usually about one hour.
The hospital stay is on average 5 to 7 days.
During this time, pain therapy, mobilization and initial gait training take place.
Afterwards, as a rule, an outpatient or inpatient rehabilitation follows to specifically build up muscle and mobility.
Many patients report that after just a few weeks they can walk independently again, climb stairs and perform simple everyday tasks.

1️⃣5️⃣ When can I walk, drive a car, or work again after the surgery?

Walking with walking aids is possible as early as the first or second day after surgery.
After about two weeks, most people can cover short distances without support.
Driving is usually allowed again after four to six weeks - depending on the individual healing process.
Light office work is possible after two to four weeks, physically demanding activities after about two to three months.
Regular physiotherapy supports recovery and ensures that the hip feels stable quickly.

16 How long does rehabilitation take after a short-stem hip replacement?

The rehabilitation usually starts immediately after discharge from the hospital and lasts on average three to four weeks.
The goal is to rebuild muscle, balance, and coordination.
Since the intervention is bone-preserving, the rehabilitation process is generally faster than with standard prostheses.
Many patients report that after about six weeks, they are largely mobile again and can climb stairs, go for walks, or ride a bike without any problems.
After three months, full resilience is achieved in most cases.

1️⃣7️⃣ How natural does walking feel with a short stem prosthesis?

One of the biggest advantages of the short-stem prosthesis is the natural feeling of walking.
Since the force transmission in the bone remains physiological and less material "replaces" the thigh, movement and balance usually feel very harmonious.
Many patients report that after a short period of adjustment, they hardly notice any differences from their natural gait.
Most even forget in everyday life that they are wearing an artificial joint – especially if the implant was positioned anatomically precise.

1️⃣8️⃣ Can you exercise with a short-stem prosthesis – and if so, which ones?

Yes, exercise is explicitly encouraged!
Recommended sports include joint-friendly activities such as cycling, swimming, hiking, Nordic walking, cross-country skiing, or moderate strength training.
High-intensity sports with jumping or rotational stress (e.g., soccer, squash, jogging) should be individually coordinated with the doctor.
In general, those who were physically active before surgery will usually be able to do so again after receiving a short stem prosthesis – often even pain-free and with significantly improved quality of life.

1️⃣9️⃣ How long does a short stem hip prosthesis last on average?

Current studies show that modern short-stem prostheses clearly achieve over 95% durability after 10–15 years – and the trend indicates that they are likely just as long-lasting as classical hip prostheses.
Since more bone is preserved, subsequent revision surgeries are simpler and associated with less risk.
Crucial for the lifespan is an exact implantation, good bone quality, and appropriate loading.
With regular check-ups and a healthy lifestyle, a short-stem prosthesis can indeed last 30 years or longer .

2️⃣0️⃣ What happens when a short-stem prosthesis needs to be replaced at some point?

Ein Prothesenwechsel wird meist nur dann nötig, wenn sich das Implantat lockert, abnutzt oder sich die Knochenstruktur verändert.
Dank des knochenschonenden Konzepts ist die Revision einer Kurzschaftprothese deutlich einfacher, da mehr gesunde Knochensubstanz erhalten geblieben ist.
In vielen Fällen kann dann sogar wieder eine Kurzschaft eingesetzt werden oder ein längerer Schaft, falls erforderlich.
In erfahrenen Händen – etwa im Endoprotheticum Rhein-Main unter Prof. Dr. Karl Philipp Kutzner – verlaufen solche Wechseloperationen routiniert und mit sehr guten Ergebnissen.

💡 Conclusion: Endoprotheticum Rhein-Main as a leading institution for short-stem hip prostheses

If you suffer from hip pain or want to know if a short stem prosthesis is suitable for you, you should contact a specialized facility.
At the Endoprotheticum Rhein-Main under the direction of Prof. Dr. Karl Philipp Kutzner you will find one of Germany's leading addresses for modern, bone-preserving hip arthroplasty – with individual advice, experience and innovative technology.