ArticleArchives of orthopaedic and trauma surgery2026
Leg length and offset in short-stem total hip arthroplasty: is a single offset-implant sufficient to restore the hip rotation centre within a range of 5 mm?
Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
introductionShort-stem total hip arthroplasty (THA) has gained popularity due to its bone-preserving properties and improved physiological load transmission to the proximal femur. Despite these advantages, the ability of short-stem implants to reliably restore leg length and offset remains debated. This study evaluates whether a single offset implant is sufficient for accurate anatomical reconstruction or if multiple offset options are necessary. MATERIAL AND
methodsA total of 148 anteroposterior pelvic radiographs of patients scheduled for short-stem THA were analysed using MediCAD® software. Femoral offset and leg length were measured, and the accuracy of anatomical reconstruction was assessed within a 5-mm target range. Comparisons were made between a single offset (130°) implant and a dual-offset system (130° and 119°) using the McNemar-Bowker test.
resultsWith a single 130° CCD (Caput-collum-diaphyseal) offset implant, 55.7% (82/148) of cases achieved satisfactory leg length and offset restoration. The use of a dual-offset system improved accuracy to 79.1% (117/148), demonstrating a statistically significant advantage (p < 0.001). DISCUSSION: The study highlights the need for at least two CCD-angle-offset combinations in short-stem THA to address anatomical variability. A dual-offset system enhances accuracy, reduces biomechanical imbalances, and therefore we expect improvements in clinical outcomes, particularly in teaching hospitals where standardization is essential.
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