Abstract / Summary
Idiopathic hip osteoarthritis is a major cause of disability worldwide, and total hip arthroplasty (THA) is the standard treatment for advanced disease; however, the independent effect of femoral stem design on functional outcomes remains unclear. This retrospective cohort study compared clinical, biochemical, and radiographic outcomes between short-stem and standard-stem hip prostheses and identified predictors of superior postoperative function. A total of 70 patients undergoing primary THA for idiopathic coxarthrosis were divided into two equal groups based on implant type. Functional outcomes were assessed using the Harris Hip Score (HHS) and WOMAC preoperatively and 6 weeks postoperatively, along with perioperative laboratory parameters and radiographic evaluation. Both groups showed significant postoperative improvements in HHS and WOMAC scores, with no significant difference in HHS between groups. The short-stem group achieved significantly better WOMAC total and function scores, whereas the standard-stem group showed slightly better stiffness outcomes. No differences were found in postoperative inflammatory response or radiographic alignment. Multivariable analysis identified stem type as the only variable significantly and independently associated with superior functional outcome, with short-stem implants associated with higher odds of favorable results. This association was robust to adjustment for baseline functional status in sensitivity analysis. These findings suggest that both designs are effective, while short-stem prostheses are associated with better early patient-reported functional outcomes at 6 weeks after THA.