Clinical comparison of THA with a standard-length or short femoral component

The purposes of this 2-part study were to determine whether reduced distal femoral component geometry allows for routinely larger component sizes to be used and whether clinical or radiographic outcomes differ between total hip arthroplasty (THA) patients treated with either standard-length or short femoral components. Femoral component size and ongrowth surface area were retrospectively compared in a group of bilateral THA patients that had both a standard-length component and a contralateral short component. Then, clinical and radiographic outcomes were compared between matched groups of THA patients that had either a standard-length or short femoral component. The use of the short component resulted in a significantly larger femoral component size being used (P=.01), and the potential ongrowth surface area was significantly larger for the short component than for the standard component (median, 36.69 vs 35.55 cm²; P=.02). In the matched-pairs analysis, no group differences were noted in modified Harris Hip Scores (P=.43) or femoral component subsidence (P=.35), but there was a significantly greater prevalence of radiolucent lines in Gruen zone 8 with the short component (P=.008). The use of a short femoral component was associated with consistently larger component sizes being used, which corresponded with a larger potential ongrowth surface area. Short-term clinical and radiographic outcomes did not differ between standard-length and short femoral components. Studies are necessary to determine whether the increased proximal ongrowth surface area may result in improved long-term fixation or, on the contrary, may increase the risk of periprosthetic fracture.