title: Short-stem hip arthroplasty in osteonecrosis of the femoral head.
abstract: BACKGROUND
  Osteonecrosis of the femoral head (ONFH) is a locally destructive and complex disorder. Without treatment, infraction of the femoral head is likely. There is also a lack of consensus in the literature about the most appropriate arthroplasty method in patients with progressive ONFH. During the last decade, the number of short-stem prostheses has increased. Some short-stem designs have a metaphyseal anchorage. It is questionable whether ONFH represents a risk factor for failure after implantation of short stems. The aim of this study was to review existing literature regarding the outcome of short-stem arthroplasty in ONFH and to present the pros and cons of short-stem hip arthroplasty in osteonecrosis of the femoral head.
  
  
  METHODS
  This review summarises existing studies on short-stem hip arthroplasty in osteonecrosis of the femoral head.
  
  
  RESULTS
  Few studies have analysed the clinical and radiological outcome of short-stem THA in patients with ONFH. Only a handful of studies present clinical and radiological outcome after implantation of a short-stem arthroplasty in patients with the underlying diagnosis of osteonecrosis of the femoral head.
  
  
  CONCLUSIONS
  The short- to medium-term results show predominantly good outcomes. However, due to differences in the design of short stems and their fixation, it is hard to draw a general conclusion. Short stems with primary diaphyseal fixation do not reveal a high increased risk of failed osseointegration or loosening. For designs with a primary metaphyseal anchorage, an MRI should be conducted to exclude that the ostenecrosis exceeds the femoral neck.
authors: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany, thilo.floerkemeier@ddh-gruppe.de.
authors: Thilo
authors: T
authors: Floerkemeier
authors: Stefan
authors: S
authors: Budde
authors: Jens
authors: J
authors: Gronewold
authors: Kerstin
authors: K
authors: Radtke
authors: Max
authors: M
authors: Ettinger
authors: Henning
authors: H
authors: Windhagen
authors: Gabriela
authors: G
authors: von Lewinski
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D005271:Femur Head Necrosis / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D063868:Patient Outcome Assessment; D011474:Prosthesis Design