Once again, the eagerly awaited report from the German Endoprosthesis Register (EPRD) provides new insights into short stem care. This is the sixth year of follow-up for our A2® short shaft – once again with outstanding results. The lime-guided system has proven itself in standard care – as can be seen in the wide range of care. Short-shaft care is becoming increasingly important again.

As in previous reporting years, the A2® short stem is at the forefront of elective cement-free hip primary care with a very low probability of failure of 2.8% within six years. The calcified stem system therefore shows excellent performance compared to cement-free anchored standard stems, which show an average failure probability of 4.0% within 6 years and 4.4% within 8 years. “These highly significant results from the register show that the A2® short socket system has proven itself as a standard socket – in a wide range of care,” explains Ulrich Bücken, Managing Director of ARTIQO GmbH.

He is also satisfied with the performance of the A2® short shaft compared to other short shafts: “The 46,147 short shafts in the follow-up show a probability of failure of 3.1% within 6 years. With the A2® shaft we are better than average here. This is a pleasing result.”

Wide range of supplies for short shafts

Patient-specific factors such as age, gender, BMI and comorbidities significantly influence the probability of failure. In the past, short stem treatment was primarily considered an option for younger and more active patients. However, this year’s EPRD annual report clearly shows that the patient population receiving short stem care is now very similar to that receiving standard care. The patients differ only minimally in the ASA classification for estimating the perioperative risk (ASA 2.2 for primary THA with standard stem; ASA 2.1 for short stem treatment). The BMI as an influencing factor for elective cement-free primary hip treatment with a standard stem is 27.9, slightly higher than the BMI of 27.8 for elective short stem treatment. If you compare the gender distribution, it is identical for the A2® short shaft and the standard shafts (40% men and 60% women). Differences can only be seen in the age range within the short shaft segment, which could be justified by the respective shaft philosophy. While the average age in elective cementless hip primary care is 67 years old, the average short stem patient in the same reporting segment is 62 years old. “The A2® short shaft is suitable for standard care because its range and depth of use means it can accommodate a variety of individual anatomies and femur morphologies. In use, this can be seen from the average patient age of 64 years,” explains Ulrich Bücken. The calcar-guided stem system is the second most frequently implanted short stem in the registry with 9,339 restorations in the follow-up.

Another significant increase in short stem care

Standard or niche? These two user philosophies can also be clearly seen in the 2023 annual report: While almost two thirds of clinics opt for a short stem for less than 5% of procedures, it is used as standard in more than 50 clinics for more than every second treatment. In general, short-shaft prostheses are seeing a renewed upward trend: in the last reporting year, the proportion of short-stem prostheses was 12%, this year it is already at 13.3% and has therefore roughly doubled since 2015.

You can find more information about the A2 shaft here: