• Thilo Floerkemeier, Stefan Budde, Jens Gronewold, Kerstin Radtke, Max Ettinger, Henning Windhagen, and Gabriela von Lewinski.
• Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany, thilo.floerkemeier@ddh-gruppe.de.
• Arch Orthop Trauma Surg. 2015 May 1;135(5):715-22.

IntroductionOsteonecrosis 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.Materials And MethodsThis review summarises existing studies on short-stem hip arthroplasty in osteonecrosis of the femoral head.ResultsFew 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.ConclusionThe 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.

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