Retrospective and Prospective Evaluation of Hip Short Stem Performed by Anterior Approach (AMISP)

Study of Short-Stem Hip Replacement Done Through an Anterior Approach

Age
18 years or above
Gender
All
participants needed
400
Locations
2
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Brief description of study

This study aims to evaluate the clinical, radiographic, and perioperative outcomes of short femoral stems implanted during primary total hip arthroplasty performed through a minimally invasive direct anterior approach (DAA). Short femoral stems have been developed to preserve proximal femoral bone stock, potentially provide a more physiological load transfer, and facilitate implantation through less invasive surgical exposures, particularly in younger and more active patients.

The stem is a cementless hydroxyapatite-coated triple-tapered short stem, has been previously used because its design allows simplified femoral canal preparation and easier implant insertion during minimally invasive anterior approaches, where femoral exposure may be technically demanding. However, previous reports have shown conflicting results regarding implant survivorship and radiographic outcomes, including increased rates of radiolucent lines, pedestal formation, and stem subsidence, particularly among younger and more active patients.

The present study will investigate the technical and clinical implications of using short femoral stems through a minimally invasive anterior approach. Primary outcomes will include perioperative complication rates, wound characteristics, peri-incisional tissue condition, postoperative bleeding, and other surgery-related complications. Secondary outcomes will include postoperative pain, functional recovery, clinical outcome scores, implant survivorship, and serial radiographic findings at short- and mid-term follow-up.

Given the limited evidence currently available regarding the short- and mid-term performance of short femoral stems implanted through the direct anterior approach, this study aims to provide a comprehensive clinical and radiographic evaluation of these implants over time. Adverse events will be continuously monitored through scheduled clinical and radiographic assessments.

Eligibility of study

You may be eligible for this study if you meet the following criteria:

  • Conditions: Hip Arthritis
  • Age: 18 years or above
  • Gender: All

Inclusion Criteria:

  • Diagnosis of primary hip osteoarthritis or osteonecrosis
  • Minimally invasive direct anterior approach
  • Cementless femoral component
  • Minimum follow-up of 2 years
  • Patient willingness to participate in the study with written informed consent
  • Age over 18 years
  • Male or female patients

Exclusion Criteria:

  • Other diagnoses of secondary hip osteoarthritis
  • Non-anterior surgical approach
  • Cemented or other types of components
  • Patient unwillingness to participate in the study
  • Inadequate clinical and radiological documentation

The purpose of this research study is to learn about the results of a specific type of hip replacement. It focuses on people who have hip replacement surgery for primary hip osteoarthritis or osteonecrosis, using a minimally invasive direct anterior approach (a front-of-the-hip surgical approach) and a cementless short femoral stem (the part placed in the thigh bone).

Participants will have their hip replacement done using the minimally invasive direct anterior approach with a cementless short stem. The study team will follow participants over time to look at surgery-related outcomes (such as complications, wound healing, and bleeding), as well as recovery outcomes (such as pain, function, and how long the implant lasts). Participants will also have X-rays over time to check the implant and bone around it.

Who can participate:
Adults with primary hip osteoarthritis or osteonecrosis may be able to participate if they:

  • Are age 18 or older
  • Have a diagnosis of primary hip osteoarthritis or osteonecrosis
  • Had a primary total hip replacement done through a minimally invasive direct anterior approach
  • Received a cementless femoral component (short stem)
  • Have at least 2 years of follow-up after surgery

Updated on 21 May 2026. Study ID: AMISP 277/2025/Oss/IOR

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