Seven cementless, press fit, rectangular cross section, titanium alloy
femoral prostheses were implanted for the treatment of displaced subc
apital hip fractures in elderly patients and retrieved postmortem for
microscopic evaluation. The mean patient age was 88 years (range, 66-1
03 years), and prostheses were in situ an average of 29 months (range,
6-45 months). Microscopic examination of the specimens revealed regio
ns of bone to prosthesis contact without interposed connective tissue,
and all were considered stably osseointegrated. The mean microscopic
bone to prosthesis contact for five cross sections was 28%. Implantati
on of this prosthesis achieved satisfactory primary stability in endos
teal cortical bone in these elderly patients, Secondary stabilization
was apparent, as evidenced by new, viable bone formation and remodelin
g in apposition to the prosthesis.