Introduction Debonding at the cement-prosthesis interface leading to stem movement and abrasion, has been proposed as initiating events in aseptic loosening of cemented total hip arthroplasties. A polished tapered or an absolutely stable stem possibly minimises this risk. This study evaluated a cemented, precoated femoral stem for stable fixation.

Methods The study included 24 patients, mean age of 64 years (48 to 78) undergoing single total hip arthroplasty for osteoarthritis. All were treated with cemented Definition (Stryker) stems which are straight, chromium-cobalt, with an integrated proximal polymethylmethacrylate mantle. One surgeon using fourth generation cementation techniques performed all surgeries. UHMWPE cups and Zirconia heads were used. At the time of surgery, tantalum markers were inserted into the femur, cement and stem for Radiostereometric analysis (RSA) of migration. Measurements were performed at two, 12 and 24 months intervals. Standard radiographs and Harris Hip Scores were obtained post-operatively and at two years.

Results During the first two years post-operatively the stems were shown to be absolutely fixed within the cement mantle and the mantle itself stable with the femur. At two years the mean subsidence of the stem in relation to the femur was 0.00 mm (SD 0.1), while the cement mantle subsided 0.2 mm (SD 0.2) in relation to the femur. The femoral head mean rotation was 0.02 retroversion. Postoperative radiolucent lines of > 1 mm where present in a mean of 1.4% (0 to 5%) of the cement-bone interfaces. This remained unchanged at two years (0 to 3%). Stems were in average positioned 0.8 in varus (1.2 valgus to 4.0 varus). Harris Hip Scores improved from a mean of 46 (23 to 68) pre-operatively to 93 (57 to 100) at two years.

Conclusions This is the first stem where no migration could be detected during the first two years. These results so far indicate good long-term performance of this precoated stem.