Calcar-guided short-stem total hip arthroplasty: Will it be the future standard? Review and perspectives  

作　　者：Karl Philipp Kutzner 

机构地区：[1]Department of Orthopaedic Surgery,St Josefs Hospital Wiesbaden,Germany,Wiesbaden 65189,Germany [2]Department of Hip Surgery,Gelenkzentrum Rhein-Main,Wiesbaden 65183,Germany [3]Center of Orthopedics and Traumatology,Johannes Gutenberg-University of Mainz,Mainz 55131,Germany

出　　处：《World Journal of Orthopedics》2021年第8期534-547,共14页世界骨科杂志（英文版）

摘　　要：Short stems in total hip arthroplasty(THA)are becoming increasingly popular.In Germany,already 10.4%of all primary THAs are performed using a cementless short stem.The concept of modern,calcar-guided,short stems aims for an individualized reconstruction of the hip anatomy by following the calcar of the femoral neck,a bone-and soft-tissue-sparing implantation technique,and physiological loading.The stem design uses either metaphyseal fixation alone or additional diaphyseal anchoring,depending on the stem alignment and indication.These individualized anchorage types increase the potential indications for the safe use of a short stem.The design features may account for potential advantages of current short stem implants compared with earlier shortstem designs,particularly in cases of reduced bone quality or osteonecrosis of the femoral head and femoral neck fractures.The implantation technique,however,requires distinct knowledge regarding the characteristics of varus and valgus positioning,with the potential for clinical consequences.A learning curve for surgeons new to this technique must be taken into account.Cortical contact with the distal lateral cortex appears to be crucial to provide sufficient primary stability,and the use of intraoperative imaging to identify“undersizing”is highly recommended.Current results of several national registries indicate that calcarguided short stems are among the most successful implants in terms of mid-term survivorship.However,long-term data remain scarce.This review introduces the characteristics of calcar-guided short-stem THA and summarizes the current evidence.

关 键 词：Total hip arthroplasty Short stem Calcar-guided Classification INDICATIONS ANCHORAGE Optimys 

分 类 号：R687.4[医药卫生—骨科学]