Introduction: Given the increasing demand for improved quality of life, there has been an uptrend in the Total Hip Arthroplasty (THA) combined with prolonged life expectancy will eventually increase the number of revision surgeries to be performed. Stress shielding is one of the major problems with regular femoral stems used in THA which makes revision surgery difficult especially in younger patients. Hence the renewed interest in investigating the safety and functional outcomes of the short metaphyseal femoral stems which can potentially mitigate this problem and can make revision surgery easier. This study was done to know the outcome of THA with short stem in long-term follow-up.
Methods: In this study we included a total of 124 hips who underwent THA using short femoral stem (TRILOCK® Depuy) between May 2006 and November 2008. Patients were followed-up for a period of 15 years. Results were assessed for pain relief, range of motion of hip joint & improvement of mobility, and functional outcome using Modified Harris hip score, OXFORD & WOMAC scores.
Results: A total of 124 hips in 98 patients were included in the study. We found significant improvement in functional outcomes on long term follow-up of 15 years and no incidence of subsidence, implant loosening or any complication requiring revision surgery till 15-year follow-up. No complications were found in any of the patients except for heterotopic ossification noted in one patient.
Conclusion: Short metaphyseal stem can be used safely in patients with adequate bone support to preserve the bony and soft tissue anatomy as it gives better functional outcomes with earlier mobilisation. Even on long-term follow-up, we found no reports of subsidence, implant loosening or bone loss due to stress shielding. This will also help in simplifying the revision by preserving bone stock especially in younger patients.

Keywords:Hip arthroplasty; Hip replacement; Metaphyseal stem; Surgery