60 patients scheduled for total hip arthroplasty were randomized to have the procedure completed using either a standard femoral stem or short femoral stem, 35mm shorter than a standard length stem. Patients were assessed over a 24-month follow-up period for periprosthetic bone mineral density on dual energy x-ray absorptiometry (DEXA) and implant stability on radiosterometric analysis. After 24 months, no significant differences between groups were observed in the change in bone mineral density in Gruen zones 1, 5, and 7, nor in implant maximum total point motion. No stems were revised in either group and patient-reported outcomes were similar.