Cementless femoral stems: Is there an optimum?

The use of cementless fixation in total hip arthroplasty has been associated with excellent results in several long-term follow-up studies. A majority of total hip arthroplasty performed in the United States has capitalized on this concept, utilizing both cementless acetabular and femoral components. Since the advent of cementless fixation, there has been a substantial evolution in femoral stem design. The individual stem geometry and the location of the porous coating for bone ingrowth are critical to the surgical technique for bone preparation and guide the ensuing success, complications, and even potentially the postoperative rehabilitation.