Comparing the long-term results of two uncemented femoral stems for total hip arthroplasty

327 proximal and 185 extensively coated femoral stems with mean 10-year follow-up were reviewed. Implant survivorship, clinical outcomes, and radiographic analyses were compared. Kaplan-Meier implant survivorship was 97.5% for the proximal, and 98.8% for the extensively coated stem for stem-only revisions at 10-years. The proximally coated stem outperformed on the PCS arm of the SF-12 (P = 0.04) and stiffness arm of the WOMAC (P = 0.03). Otherwise, all clinical outcomes were comparable. Thigh pain incidence was 12.5% and 5.3% for the extensive versus proximally coated groups, respectively (P = 0.007). Radiographic review identified more severe stress shielding (P < 0.001) in the extensively coated stems. This study supports the long-term clinical track record of total hip arthroplasty using two different cementless stem designs.