The decision between a short-stem prosthesis and a traditional hip replacement is one of the most important questions patients face before undergoing hip replacement . Both systems share the same goal: to eliminate pain, restore mobility, and ensure stable joint function for decades. However, the way this goal is achieved differs significantly. This is precisely where false or unrealistic expectations , which can be avoided with a clear understanding of the differences.

The short-stem prosthesis has clearly become the standard in hip arthroplasty in recent years – and for several good reasons. Modern implants of this design now allow for bone-conserving, soft-tissue-sparing, and anatomically correct treatment, which offers enormous advantages, especially for younger and active patients.

One of the most important reasons for its success is that the short-stem prosthesis preserves more of the patient's own bone , particularly in the femur. This helps to better maintain the natural force distribution, and subsequent revision surgeries can be performed much more easily and with less invasive techniques. Furthermore, modern short stems offer flexible fixation options: they provide both stable metaphyseal fixation and – depending on the model – mixed fixation extending into the proximal femur.

Functionally, short-stem prostheses now deliver extremely convincing results. Many patients report a natural feeling of movement good rotational stability and high load-bearing capacity are particularly crucial.

Another success factor: The development of modern surgical approaches – such as the muscle-sparing direct anterior approach (DAA) – harmonizes particularly well with short-stem prostheses. This allows patients to benefit from smaller incisions, less soft tissue irritation, and faster mobilization .

In summary, the short-stem prosthesis has become the standard because it:

• bone-saving and therefore future-proof.
• Natural movement enables
• Rapid rehabilitation supported
• The best options for later revisions are offered
• an ideal combination with modern, minimally invasive approaches.

The short stem prosthesis thus fulfills exactly what many hip patients desire: a durable, stable and at the same time body-hugging solution that enables an active life.

Different philosophies: preservation vs. replacement

For decades, the classic hip replacement has followed a proven principle:
The long prosthetic stem is anchored deep in the femur and takes over a large part of the force transmission. This procedure is reliable, but it also means that a relatively large amount of bone is removed.

The short-stem prosthesis follows a more modern and significantly bone-conserving strategy. The stem is considerably shorter, anatomically adapted, and primarily utilizes the stable region in the upper femur for fixation. This allows for:

• Less bone loss compared to standard prostheses
• More natural force transmission to the femur
• A more physiological feeling of movement , as the anatomical structures are better preserved.

For patients, this often means a gentler procedure and faster confidence in the new joint.

Differences in surgical technique

While classic, long stems require a relatively deep drilling in the femur, the surgeon often works with a short stem prosthesis:

• with smaller access points ,
• less soft tissue injury,
• and targeted preparation of the upper femur area.

This is technically demanding, but when performed by experienced hip specialists, patients benefit from:

• less postoperative pain symptoms,
• faster rehabilitation times,
• and the previous load-bearing capacity of the operated leg.

This is a significant advantage, especially for active people or patients who want to quickly return to their everyday lives.

Difference in long-term behavior

Although both types of prostheses offer very good durability, the quality of the remaining bone plays an important role in long-term planning.

Classic prosthesis:

• Proven for decades
• very stable long-term results
• A common choice in cases of poor bone quality or very advanced age

Short stem prosthesis:

• also very good results, especially in the last 10–15 years
• Ideal for patients who realistically might require a later prosthesis replacement at some point
• The preserved bone makes a later revision technically simpler and less invasive

For many patients, this point is crucial:
A short-stem prosthesis protects long-term options – an advantage that counts considerably for younger patients.

What does this mean for patients in concrete terms?

The most important points at a glance:

• A short stem prosthesis is not simply a "small standard prosthesis", but a well-thought-out, modern implant with its own philosophy.
• The surgery can be less invasive and leads to faster mobility .
• Expectations should remain realistic: Even an artificial hip joint with a short stem is an implant – but one that often provides a more natural feeling .
• With good bone quality, it is a high-quality option that offers greater flexibility in the long term.

This makes it clear: The choice between short and long surgery is not just a technical decision, but affects the entire treatment process – from surgical risks to rehabilitation and future treatment options.

Why has the short-stem prosthesis become so popular?

The short-stem prosthesis has become the standard because it conserves bone, is anatomically correct, and future-proof. It preserves more of the patient's own bone, allows for a more natural feeling of movement, and facilitates future revision surgeries. Furthermore, patients benefit from faster rehabilitation, high stability, and ideal compatibility with muscle-sparing surgical approaches such as the DAA.

Expert advice: Why short-term employment is often the first choice today

Among the leading specialists for short-stem prostheses in Germany is Prof. Dr. med. Karl Philipp Kutzner , head of the Endoprosthetics Center in Mainz. His many years of scientific and surgical experience clearly demonstrate that modern short stems represent the more stable, biologically sound, and sustainable long-term solution for many patients.

At the Endoprosthetics Center, patients benefit from precise diagnostics, a detailed analysis of their expectations, and consultation to determine which hip prosthesis is truly the best fit, both anatomically and functionally. Professor Kutzner frequently recommends short-stem prostheses, especially for younger and athletically active patients, as these offer optimal conditions for high mobility, reduced bone damage, and long-lasting implant stability

Anyone who wants to know whether a short stem prosthesis is the right option will find a particularly well-founded and individual assessment at Endoprostheticum – based on genuine specialization and comprehensive surgical experience.