Observational studyBMC geriatrics2019
Cementless short-stem total hip arthroplasty in the elderly patient - is it a safe option?: a prospective multicentre observational study.
Observational study in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 68 citations in OpenAlex.
- Risk factors for periprosthetic femoral fractures following hip arthroplasty: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Results of an Ultra Short Metaphyseal Filling Cementless Stem in Primary Total Hip Arthroplasty: Mean 12.1-Year Follow-up.Indian journal of orthopaedics · 2026Article
- Short Femoral Stem Performance in Femoral Hip Fracture: Clinical and Radiological Evaluation and Comparative Study of Patients Older than 65 Years.Medicina (Kaunas, Lithuania) · 2026Article
- Article
- [Short-stem THA-complications and therapy options].Orthopadie (Heidelberg, Germany) · 2025Article
- Same same but different: Introduction of a classification system in calcar-guided short-stem total hip arthroplasty.Hip international : the journal of clinical and experimental research on hip pathology and therapy · 2025Article
- Mid-term outcomes after primary total hip arthroplasty with a cemented short stem in an elderly patient cohort.Archives of orthopaedic and trauma surgery · 2024Observational
- Mid- to long-term periprosthetic bone density changes after cementless short stem hip arthroplasty in elderly: A clinical and radiological analysis.Journal of orthopaedics · 2024Article
- Cementless short stem total hip arthroplasty in patients older than 75 years: is it feasible?Archives of orthopaedic and trauma surgery · 2024Article
- No differences in clinical and radiographic outcomes between standard offset and high offset short cementless stems.Archives of orthopaedic and trauma surgery · 2024Article
- Radiological Comparison of Canal Fill between Collared and Non-Collared Femoral Stems: A Two-Year Follow-Up after Total Hip Arthroplasty.Journal of imaging · 2024Article
- Calcar-guided short-stem total hip arthroplasty in fractures of the femoral neck: a prospective observational study of 68 hips.Archives of orthopaedic and trauma surgery · 2024Observational
- Article
- Comparison of canal fill and radiolucent line formation between two fully coated, hydroxyapatite tapered stems: a 2-year follow-up after total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2023Article
- A propensity score-matched analysis on the impact of patient and surgical factors on early periprosthetic joint infection in minimally invasive anterolateral and transgluteal total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2023Article
- Digital templating cementless short stem total hip arthroplasty: is there a difference in planning adherence between the direct anterior approach and minimally invasive anterolateral approach?Archives of orthopaedic and trauma surgery · 2023Article
- Survival and performance of a dual tapered-wedge fully HA-coated press fit femoral stem.Archives of orthopaedic and trauma surgery · 2023Article
- Survivorship, complications and patient-reported outcomes in calcar-guided short-stem THA: prospective mid-term multicenter data of the first 879 hips.Archives of orthopaedic and trauma surgery · 2023Article
- The 'critical trochanter angle' does not show superiority over the CCD angle in predicting varus stem alignment in cementless short-stem total hip arthroplasty.Archives of orthopaedic and trauma surgery · 2023Article
- Is it reasonable to shorten the length of cemented stems? A finite element analysis and biomechanical experiment.Frontiers in bioengineering and biotechnology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDue to its bone preserving philosophy, short-stem total hip arthroplasty (THA) has primarily been recommended for young and active patients. However, there may be benefits for elderly patients given a less invasive operative technique due to the short curved implant design. The purpose of this study was to compare the clinical and radiological outcomes as well as perioperative complications of a calcar-guided short stem between a young (< 60 years) and a geriatric (> 75 years) population.
methodsData were collected in a total of 5 centers, and 400 short-stems were included as part of a prospective multicentre observational study between 2010 and 2014 with a mean follow-up of 49.2 months. Preoperative femur morphology was analysed using the Dorr classification. Clinical and radiological outcomes were assessed in both groups as well as perioperative complications, rates and reasons for stem revision.
resultsNo differences were found for the mean visual analogue scale (VAS) values of rest pain, load pain, and satisfaction, whereas Harris Hip Score (HHS) was slightly better in the young group. Comparing both groups, none of the radiological parameters that were assessed (stress-shielding, cortical hypertrophy, radiolucency, osteolysis) reached differences of statistical significance. While in young patients aseptic loosening is the main cause of implant failure, in the elderly group particularly postoperative periprosthetic fractures due to accidental fall have to be considered to be of high risk. The incidence of periprosthetic fractures was found to be 0% in Dorr type A femurs, whereas in Dorr types B and C fractures occurred in 2.1 and 22.2% respectively.
conclusionsAdvanced age alone is not necessarily to be considered as contra-indications for calcar-guided short-stem THA, although further follow-up is needed. However, markedly reduced bone quality with femur morphology of Dorr type C seems to be associated with increased risk for postoperative periprosthetic fractures, thus indication should be limited to Dorr types A and B.
trial registrationGerman Clinical Trials Register; DRKS00012634 , 07.07.2017 (retrospectively registered).
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