Aims: The original M.E. Mueller straight stem is used as standard implant for primary hip replacement with cement fixation in our hospital since 1982. Methods: During the last 20 years in our department 5110 Mueller straight stems were implanted for hip replacement. 4054 cases of arthritis of the hip joint, 883 femoral neck fractures and 173 cases of revision were treated with this implant.

109 patients out of 1982 and 1983 were re-examined after 5 years clinical and radiological. After 20 years dates out of 128 patients of a group of 200 (65%) from 1982/83 are available.

In a third group from 489 femur neck fractures cases between 1987 and 1996 101 patients could be verified and their complications analysed Results: After 5 years from 158 patients 26 had deceased and 23 were lost. In the remaining group were 9 local and 8 general complications. Two cases had revisions. After 20 years 72 out of 200 were lost 65 had deceased. From 128 patients in this trial 19 had a revision of stem. 109 patients still lived with their first replacement. The surveillance rate is 82,5%

In the group of 101 re-examined patients with straight stems after femur neck fracture 3 cases had revision, 2 out of dislocation and 1 with deep infection. Conclusions: With the experience of 5110 implantations of Mueller straight stems during the last 20 years, a very small rate of complications and a surveillance of 82,5% this implant is a standard in cemented fixation in primary hip replacement.