The use of short cementless femoral stems in total hip arthroplasty for femoral neck fractures: a scoping review of the literature.

BACKGROUND

Short cementless femoral stems, designed for bone-preserving elective THA, are increasingly used for femoral neck fractures, yet their safety and effectiveness remain unclear.

OBJECTIVE

To map current evidence on short cementless stems in fracture-related THA, focusing on complications, function, and revisions.

METHODS

MedLine and Web of Science were searched to 30 April 2025. Studies reporting ≥ 5 THAs with short cementless stems for femoral neck fractures were included; data were charted and narratively synthesized.

RESULTS

Five studies (477 short-stem, 70 standard-stem THAs; mean age 63 years; mean follow-up 65 months) met criteria. Short stems showed a 4.4% complication rate (0.6% intra-op fractures, 0.6% dislocations, 2.1% aseptic loosening) and 3.7% reoperations. Mean Harris Hip Score was 86.8-comparable to standard stems-with fewer surgical complications (4.4 vs. 15.7%).

CONCLUSION

Current evidence suggests short cementless stems are a safe, effective option for selected femoral neck fracture patients, but higher-quality, long-term studies are needed.