CEMENTLESS FEMORAL DESIGN CONCERNS - RATIONALE FOR EXTENSIVE POROUS COATING

In the early 1980s increased interest in proximally porous coated stem s was sparked by first generation cemented stem failures in young pati ents and concerns with extensively porous coated cementless stems rega rding thigh pain and stress shielding. As a result, various proximally porous coated stems were produced, each with differing clinical resul ts. Using 5-year minimal followup as a cut off, the evolution of proxi mally porous coated stems during the years is presented and compared w ith the long term results obtained with extensively porous coated stem s. Problems with some of the early proximally coated designs have been reported in the literature. Despite subsequent design modifications, the modern proximally coated seem has not eliminated thigh pain or str ess shielding. Although some of the proximally porous coated stems hav e had good results, the question whether the push for proximally coate d femoral stems resulted in significant clinical improvement versus th e long term results of extensively porous coated stems remains.