Congratulations on the 50,000th implantation of the A2 short stem! In your opinion, what is the secret of the A2® short stem’s success?

Ulrich Bücken: We are very pleased about the broad acceptance of the A2® short shank system on the market. You could also say that our idea has been a success! The question for the development of the A2® short stem at the time was: How should a short stem system be designed so that it can address as many individual anatomies and femoral morphologies as possible as standard?

The result is the calcar-guided short stem system as our customers know it today. It offers a great deal of anatomical variability in terms of taper angle and calcar radius. All in all, we are providing a well thought-out and contemporary short stem system that is very well suited for minimally invasive approaches and can cover a wide range of indications – just like a standard stem.

For a wider range of indications, the cemented A2 short stem has also been available for 4 years. This means that ARTIQO still has a unique selling point. How is the cemented version accepted?

Ulrich Bücken: We get very good feedback from our customers. Convinced short stem users want the short stem advantages – bone preservation, anatomical reconstruction, antetilt position, minimal invasiveness – to also benefit older patients with poor bone quality and difficult Dorr type C morphologies.

The cemented A2® short stem is therefore a useful addition to the product range and has been very well received. In the last annual report of the Endoprosthesis Register Germany (EPRD), the cemented A2® short stem appeared in the follow-up for the first time. We are looking forward to the further development of this “family member”.

It is almost a tradition that the A2® short stem shows outstanding results in the EPRD’s annual reports. Is this also a reason for the system’s acceptance among customers?

Ulrich Bücken: It is a pleasure to see how good the register data for the A2® short stem is. In the 2024 annual report, the cementless A2® Short Stem once again scored highly with a very low failure probability of 2.7% within seven years. This makes our system one of the leading systems in elective cementless primary hip replacement, in which short and standard stems are tracked equally.

I am sure that the EPRD performance data is an important basis for deciding for or against a stem system. There are currently 3 million cases documented there. The EPRD is now the No. 2 register in Europe and No. 3 worldwide.

What’s your outlook for the future?

Ulrich Bücken: Basically very positive. We are already seeing almost no contraindications in standard elective care. Short-shaft treatment set another record last year. According to the EPRD, a short stem was implanted in 15.1% of cases in 2023. I assume that the proportion will continue to rise significantly in the coming years.

At the same time, caution will continue to be required in the future: in the EPRD evaluation, we see that the A2® short stem achieves the best results in clinics that have developed a corresponding user routine. This is why we offer further training and an intensive professional exchange for new users. With a view to the results that we all want, it is also important that the short stem is not just seen as a niche product for a few selected patients, but that it is actually used on a broad scale.

And this brings us to another topic where I would like to see prudence: we have the valuable insights I just mentioned because the EPRD provides us as a manufacturer with annual performance evaluations of our products. The EPRD is an established resource that specialist societies, health insurance funds and industry have created together and which now reliably reflects the reality of care in hip and knee arthroplasty. This must also remain the case under the auspices of a new implant registry (IRD), as is currently being planned by the Federal Ministry of Health.

The interview was conducted by Michaela Rau