The role of surface finish on the survivorship of cemented stems is controversial. The purpose of this study is to prospectively evaluate the mid-term clinical and radiographic performance of a cohort of patients who underwent total hip replacement with two identical cemented femoral stems differing only in surface finish (VerSys, Zimmer, Warsaw, IN). 64 total hip replacements with a rough stem and 138 total hip replacements with a satin finish stem were followed clinically and radiographically for 4 to 7 years. All surgeries were performed by one surgeon. The groups had similar demographics, diagnosis, length of follow up, cement mantle quality and alignment. The preoperative and postoperative Hospital for Special Surgery Hip Score at last follow up was not significantly different among the two groups. Five hips in the rough group and none in the satin group developed aseptic loosening (p=0.0009). The femoral bone-cement interface revealed progressive radiolucent lines or osteolysis in 8 out of 64 rough stems and in 3 out of 138 satin stems (p=0.01). There were progressive radiolucencies or osteolysis in 44 out of possible 448 Gruen zones in the rough surface group and in 8 out of possible 966 Gruen zones in the satin finish group (p< 0.001). A rough, textured stem is more likely to fail at intermediate follow-up than a satin surface stem. We recommend that the surface of cemented stems should be satin or polished, with a Ra of less than 20 microinches.

First generation uncemented modular cups reproduciblyfixed to bone but they were associated with unacceptable rates of pelvicosteolysis and mechanical failure. Consequently, second generation cups weredeveloped with shells having a limited number of holes or no holes, and improved conformity and locking mechanisms with the liner. The purpose of this study is to report the clinical and radiographic results of a second generation acetabular component for primary total hip arthroplasty.

297 patients who underwent 335 consecutive primary total hip arthroplasties by a single surgeon with the Trilogy modular acetabular component were followed clinically with the Hospital for Special Surgery Hip Scoring System and radiographs, for 4 to 7 years. All cups were implanted with a press-fit technique.

This second generation acetabular cup design achieved predictable fixation and was associated with a low prevalence of revision for loosening and low prevalence of osteolysis at an intermediate follow up.

The role of surface finish on the survivorship of cemented stems is controversial. The purpose of this study is to prospectively evaluate the mid-term clinical and radiographic performance of a cohort of patients who underwent total hip replacement with two identical cemented femoral stems differing only in surface finish (VerSys, Zimmer, Warsaw, IN).

64 total hip replacements with a rough stem (Ra: 70–100 micro inches) and 138 total hip replacements with a satin finish stem (Ra: 20–25 micro inches) were followed clinically and radio graphically for 4 to 7 years. All surgeries were performed by one surgeon, during a period of 1 year, utilizing the same surgical approach and technique, ace tabular cup, cement type and cementing technique. The groups had similar demographics, diagnosis, preoperative clinical score, cement mantle quality, alignment, and length of follow up.

The preoperative and postoperative Hospital for Special Surgery Hip Score at last follow up of the patients with a successful operation was not significantly different among the two groups. Five hips in the rough group and none in the satin group developed aseptic loosening and required revision (p=0.0009). The femoral bone-cement interface revealed progressive radiolucent lines or osteolysis in 8 out of 64 rough stems and in 3 out of 138 satin stems (p=0.01). There were progressive radiolucenciesor osteolysis in 44 out of possible 448 Gruen zones in the rough surface group and in 8 out of possible 966 Gruen zones in the satin finish group(p< 0.001).

A rough, textured stem is more likely to fail at intermediate follow-up than a satin surface stem. We recommend that the surface of cemented stems should be satin or polished, with a Ra of less than 20 micro inches.

The role of surface finish on the survivorship of cemented stems is controversial. The purpose of this study is to prospectively evaluate the mid-term clinical and radiographic performance of a cohort of patients who underwent total hip replacement with two identical cemented femoral stems differing only in surface finish (VerSys, Zimmer, Warsaw, IN). 64 total hip replacements with a rough stem (Ra: 70–100 microinches) and 138 total hip replacements with a satin finish stem (Ra: 20–25 microinches) were followed clinically and radiographically for 4 to 7 years. All surgeries were performed by one surgeon during a period of 1 year, utilizing the same surgical technique, acetabular cup, cement type and cementing technique. The groups had similar demographics, diagnosis, preoperative clinical score, cement mantle quality, alignment, and length of follow up. The preoperative and postoperative Hospital for Special Surgery Hip Score at last follow up of the patients with a successful operation was not significantly different among the two groups. Five hips in the rough group and none in the satin group developed aseptic loosening (p=0.0009). The femoral bone-cement interface revealed progressive radiolucent lines or osteolysis in 8 out of 64 rough stems and in 3 out of 138 satin stems (p=0.01). There were progressive radiolucencies or oste-olysis in 44 out of possible 448 Gruen zones in the rough surface group and in 8 out of possible 966 Gruen zones in the satin finish group (p< 0.001). A rough, textured stem is more likely to fail at intermediate follow-up than a satin surface stem. We recommend that the surface of cemented stems should be satin or polished, with a Ra of less than 20 microinches.