25dkou375 10.3205/25dkou375 urn:nbn:de:0183-25dkou3757 Meeting Abstract Leitner Leitner Lukas L

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Munich, Deutschland

author Simon Simon Dominic D

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Munich, Deutschland

author Rammel Rammel Katrin K

Department of Orthopedics and Trauma, Medical University of Graz, Graz, Österreich

author Ruckenstuhl Ruckenstuhl Paul P

Department of Orthopedics and Trauma, Medical University of Graz, Graz, Österreich

author Lerchenberger Lerchenberger Maximilian M

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Munich, Deutschland

author Beckers Beckers Gautier G

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Munich, Deutschland

author Holzapfel Holzapfel Boris B

Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, Munich, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20251031 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0634 375 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025) Abstracts | Gelenkersatz – Hüfte Berlin 20251028 20251031 AB57-4559 TextObjectives and questions: Registry data indicate a growing use of short-stem systems with uncemented fixation, likely due to their technical advantages in minimally invasive implantation. Literature increasingly reports their application, even in rare indications such as femoral neck fractures. As a result, an increased number of well-osteointegrated short stems requiring revision can be expected in the future. This study aimed to analyze risk factors and potential challenges in revision cases and to review the existing literature on this topic.Material and methods: A retrospective database analysis was conducted at two university centers (Germany and Austria) from 2022 onwards. Inclusion criteria were the extraction of a well osteointegrated short-stem system (minimum of six months post-implantation). Patient-specific risk factors and intraoperative complications were recorded. A PubMed analysis was performed for research on relevant literature.Results: Ten patients (4 female; age: 66.3 ± 13.9 years) with short stems requiring extraction after completed osteointegration (6.1 ± 5.2 years post-implantation) were identified. Indications for revision included infection (n=5), periprosthetic fracture (n=4), and metallosis (n=1). Stem removal resulted in calcar destruction in seven cases and trochanteric fracture in eight cases, with four requiring additional osteosynthesis. Modular revision stems were necessary in seven cases. A PubMed search for the specific research question yielded no relevant results on this specific topic.Discussion and conclusions: Extraction of osteointegrated short stems posed a high risk of trochanteric destruction, leading to additional instability. The frequent necessity for modular revision stems contradicted the concept of a “bone-preserving” revision. Particularly in cases of pronounced distal/diaphyseal fixation (valgus neck configuration, Dorr-B femur) with plasma-spray-coated implants, the typical curvature of short stems complicated extraction. We recommend careful preoperative indication assessment, considering future revision requirements. 0 0 0 0