PURPOSE Due to improved prosthesis designs and surgical techniques, indications for total hip arthroplasty (THA) now include younger and more active patients. Preserving bone stock and soft tissue in these patients is paramount to allow for future revision. Designed for anatomical reconstruction, short femoral stems have the potential to reduce adaptive bone loss and stress shielding. To confirm this, we evaluated bone remodeling around a short femoral stem and the accuracy of hip joint reconstruction. METHODS This prospective observational study involved 46 patients with short-stem THA for clinical and radiographic analysis. We evaluated bone remodeling by Gruen zone using dual-energy X-ray absorptiometry in 45 patients and assessed the accuracy of hip joint reconstruction using caput-collum-diaphyseal angles. Additionally, we reported functional scores and pain. RESULTS Patients were followed for a mean of 24.1 (SD 2.2) months. Bone mineral density increased mainly in the lateral region (Gruen zones 2 and 3) and in the distal-medial region (Gruen zone 5), suggestive of lateral loading. Most caput-collum-diaphyseal angles remained stable after surgery, especially in patients with varus hips. Harris Hip Scores improved significantly, from 57.2 (SD 20.0) pre-operatively to 97.2 (SD 4.0) at 24 months post-operatively (P < 0.0001). Finally, we encountered one peri-operative dislocation but no post-operative complications. CONCLUSION Short femoral stems successfully limited stress shielding and minimized periprosthetic bone loss without compromising primary stability. We were able to accurately reconstruct anatomical relationships in most patients. Finally, excellent clinical outcomes and low complication rates confirmed the favourable results of short-stem THA. TRIAL REGISTRATION DRKS00017076.

中文翻译：

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短茎全髋关节置换术后股骨的重塑：一项前瞻性光密度研究。

目的由于改良的假体设计和手术技术，目前全髋关节置换术（THA）的适应症包括年轻和活跃的患者。在这些患者中，保留骨储备和软组织至关重要，以便将来进行修复。专为解剖重建而设计，股骨短茎具有减少适应性骨丢失和应力屏蔽的潜力。为了证实这一点，我们评估了股骨短茎周围的骨重塑以及髋关节重建的准确性。方法这项前瞻性观察性研究涉及46例短柄THA患者，用于临床和影像学分析。我们评估了45例患者使用双能X线骨密度测定法通过Gruen区域进行的骨重塑，并使用角膜-胶质-干dia端角度评估了髋关节重建的准确性。另外，我们报告了功能评分和疼痛。结果患者平均随访24.1（SD 2.2）个月。骨矿物质密度主要在外侧区域（Gruen区域2和3）和远端内侧区域（Gruen区域5）增加，提示有横向负荷。手术后大多数Caput-Collum-干dia端角度保持稳定，尤其是髋内翻患者。Harris Hip评分显着提高，从术前的57.2（SD 20.0）到术后24个月的97.2（SD 4.0）（P <0.0001）。最后，我们遇到了一次围手术期脱位，但没有术后并发症。结论股骨短柄成功地限制了应力屏蔽，并最大程度地减少了假体周围的骨质流失，而没有损害主要稳定性。我们能够准确地重建大多数患者的解剖关系。最后，出色的临床疗效和较低的并发症发生率证实了短柄THA的良好疗效。试用注册DRKS00017076。