A series of total hip replacements was per-
formed using a proximally porous coated, tapered femo-
ral stem system. At a mean follow-up of 8.1 (5–13)
years, 80 out of 107 hips were available for clinical and
radiological examination. The mean age at the index pro-
cedure was 58.6 years. The mean Harris Hip Score at fi-
nal follow-up was 91.7. Radiological ingrowth was ob-
served in 77 femoral stems, 2 stems were fibrous stable
and 1 stem was loose.
Nous avons realisé une étude rétrospective
comprenant 80/107 prothèses totale de la hanche en utili-
sant une tige fémorale avec fixation proximale non-
cimentée. L`age moyen des patients lors de l`interven-
tion était de 58.6 ans. La durée moyenne d`observation
post-opératoire était de 8.1 ans. Le score de Harris lors
du dernier examen clinique était de 91.7. Une incorpora-
tion radiologique idéale était observée dans 77 tiges, 2 ti-
ges étaient stables et 1 tige était descellée.
With the increasing number of total joint replacement pro-
cedures and cost reduction programs, clinical follow-up
studies revealing longevity of implants are not only impor-
tant for the quality of life of the patients but may become
more and more valuable for effective cost control [11,24].
The results of such studies should have direct practical ap-
plication and implants with successful survival rates should
be favored before new designs are chosen or developed.
With growing interest in cementless implant fixation
in the last decade, especially for younger patients, mid-
to long-term follow-up data are now becoming available.
Mechanical loosening rates of non-cemented femoral
stems have been reported in several studies and fall be-
tween 0 and 48% for various follow-up periods ranging
from 3.5 to 7 years [1,2,4,6,8,12,14–17,21,26].
The purpose of this study is to report our mid-term re-
sults of a series of total hip replacements with a cement-
less, proximally porous coated, tapered stem design.
Materials and methods
Between July 1987 and November 1994, 94 patients underwent
107 non-consecutive primary cementless total hip replacements
(THA) with the Opti-Fix femoral stem (Smith and Nephew
Richards Orthopedics, Memphis, TN, USA) (Figs. 1, 2) at the
Louisville Institute for Joint Replacement and The Arthroplasty
Foundation. All procedures were performed by the three senior au-
thors (D.L.P., L.A.S., W.E.B.Jr.).
Eight patients (8 hips) died and 15 patients (19 hips) failed to
be evaluated within the past 2 years and could not be contacted.
These patients were considered lost to follow up and not included
in the study. At the time of review, 80 hips (71 patients) had com-
plete follow-up data with a mean follow-up of 97 (60–132)
months. They were evaluated clinically using Harris Hip Score
(HHS) and radiographically according to the criteria developed
by Engh . The mean age at the time of surgery was 58.6
(29–75) years. The preoperative diagnoses were: osteoarthritis in