Effect of stem alignment on long-term outcomes of total hip arthroplasty with cementless Bi-Metric femoral components

We investigated the effects of varus-valgus alignment on the long-term outcomes after cementless total hip arthroplasty (THA) using a porous coated version of Bi-Metric® femoral stems. The Kaplan-Meier survival analysis was performed in 71 hips. The survival rate with femoral revision for aseptic loosening as the end point was 100% at 17 years. Nevertheless, the initial stem alignment was more valgus in patients with the Engh grade III-IV stress shielding than patients with the Engh grade I-II. Our results suggest that valgus misalignment of cementless Bi-Metric stem might be a potential risk factor for the progression of stress shielding.