Not all cemented femoral stems are created equal: A selection algorithm

Cementless femoral stem fixation predominates in total hip arthroplasty with North America and includes various designs designated as fit and fill or double taper proximally porous coated stems, parallel sided taper wedge or “blade” stems, tapered rectangular cross-section Zweymuller-type stems, fully-porous coated cylindrical stems, Wagner-style conical shape splined titanium stems, and modular proximal sleeve stems. Regardless of the stem type, the essential tenets of long-term fixation and osseointegration remain obtaining adequate mechanical stability and intimate prosthesis contact with viable host bone. This manuscript will detail a selection an algorithm for selection of an appropriate femoral stem for a given patient anatomy.