➤ Short bone-conserving femoral stems in total hip arthroplasty were designed to preserve proximal bone stock.
➤ Given the distinct fixation principles and location of loading among these bone-conserving stems, a classification system is essential to compare clinical outcomes.
➤ Due to the low quality of currently available evidence, only a weak recommendation can be provided for clinical usage of certain stem designs, while some other designs cannot be recommended at this time.
➤ A high prevalence of stem malalignment, incorrect sizing, subsidence, and intraoperative fractures has been reported in a subset of these short stem designs.
➤ Stronger evidence, including prospective multicenter randomized trials comparing standard stems with these newer designs, is necessary before widespread use can be recommended.
1Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, 4942 Eastern Avenue, 6th Floor, Building A, Baltimore, MD 21224
2Department of Orthopaedic Surgery, Albany Medical Center, 43 New Scotland Avenue, Albany, NY 12208
3Department of Orthopedic Surgery, Dayanand Medical College and Hospital, Ludhiana, Tagore Nagar, Ludhiana, Punjab 141002, India
4Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215