OTSR - 2026-03-07 - Journal Article
Revising short-stem THA with either a new short stem or a primary stems: A feasible and durable strategy.
Kara S, Manon J, Van den Wyngart T, Poilvache H, Ramos Prieto M, Seydou D, Cornu O
Topics
Key Takeaway
Revision of failed Fitmore short-stem THA using a new short or standard primary stem achieved a 4.5% re-revision rate at mean 69 months follow-up, avoiding dedicated revision implants in 84% of cases.
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Summary
This study asked whether failed Fitmore metaphyseal short stems could be revised with non-revision implants (short or standard primary stems) rather than dedicated revision components. In 44 consecutive revisions, 37 of 44 cases (84%) were managed with a short stem (n=11) or standard primary stem (n=26), with only 7 requiring a true revision stem. At mean 69 months, mean Harris Hip Score was 82.3 ± 8.4 and re-revision rate was 4.5% (n=2: one traumatic periprosthetic fracture, one hematogenous infection).
Key Limitation
The absence of radiographic bone stock grading (e.g., Paprosky classification) for each revised case makes it impossible to determine which bone stock profiles actually permitted downgraded implant selection, limiting generalizability.
Original Abstract
BACKGROUND
Short-stem total hip arthroplasty (THA) has gained popularity due to its bone-preserving design, reduced stress shielding, and facilitation of future revisions. However, concerns persist regarding a higher incidence of complications especially during the learning curve. The feasibility of revising Fitmore short stems using either a new short or a standard primary stem, rather than dedicated revision implants, remains debated.
METHODS
We retrospectively reviewed 44 consecutive revisions following primary implantation of a Fitmore® metaphyseal short stem. Revision femoral components were classified as short, primary, or revision stems. Indications for revision, stem choice, and outcomes were analyzed.
RESULTS
Revision was performed using a short stem in 11 cases, a standard primary stem in 26 cases, and a revision stem in 7 cases. Mean follow-up was 69 months. The mean Harris Hip Score was 82.3 ± 8.4. Two patients (4.5%) required re-revision, one due to traumatic periprosthetic fracture and the other for hematogenous infection.
CONCLUSION
Revision of failed short-stem THA using new short stem or standard primary stems is feasible in the vast majority of cases, with excellent mid-to long-term outcomes and a low re-revision rate. These findings challenge the notion that short stem revisions inherently require complex revision implants.
LEVEL OF EVIDENCE
IV; Retrospective consecutive case series.