Primary total hip replacement using a tapered rectangular stem without porous surface

Purpose of review: The present review aims to inform orthopedic surgeons regarding a broached rectangular straight stem which has provided excellent long-term results for stem survival. Recent findings: The tapered rectangular femoral stem for hip replacement has been used in its current design since 1986. Implanting the stem requires no reaming and uses broaching for canal preparation. The stem design is such that a fit and fill of the canal is not required and bone ongrowth provides long-term stem stability. Implantation of the stem is straightforward and initial stability is related to the rectangular shape of the stem, which resists rotational and torsional stresses. The stem may be implanted in bone varying from normal to osteoporotic and for a variety of hip problems. General experience over the last 20 years has demonstrated a greater than 98% success rate of the stem with respect to aseptic loosening. Summary: The longevity of a tapered uncemented straight stem has been validated in several studies and should be considered for patients requiring hip replacement.