Catastrophic failure of cementless total hip arthroplasty using a femoral component without surface coating

Consecutive series of 90 hips that had had a primary cementless arthroplast y with use of straight collarless stems between January 1988 and September 1992 were reviewed. Twenty-eight hips with Omnifit Normalized Stents (Fit-N ) and 45 hips with Omniflex Normalized Stems (Flex-N) without porous coatin gs were compared clinically and radiographically with 17 hips with Omnifit Microstructured Stems (Fit-M) with porous coating. The average follow-up pe riods for the 3 stems were 97 months, 73 months, and 93 months. Revision wa s performed or awaited in 9 cases (32.1%) in the Fit-N group, 18 cases (40. 0%) in the Flex-N group, and 1 case (5.8%) in the Fit-M group. The average annual subsidence was 0.62 mm/y, 0.73 mm/y, and 0.17 mm/y. Osteolysis of mo re than 3 mm occurred in 28.6%, 37.8%, and 23.5%. Fit-N stems and Flex-N st ems without porous coatings are not appropriate for cementless total hip ar throplasty.