Tapered cementless femoral stem: Difficult to place in varus but performs well in those rare cases

This retrospective review was conducted to determine the incidence and minimum 5-year follow-up of varus placement of a tapered, proximally plasma-sprayed, titanium femoral component. Twenty-six (2.4%) of 1080 components were placed in >= 5 degrees of varus in primary cementless total hip arthroplasty at one institution. Harris hip scores improved an average of 50 points. One stem was revised for malposition at 2.5 years, yet was well-fixed by radiographic criteria. Survival with aseptic loosening as an end-point is 100% with an overall femoral component survival of 96% at an average 10-year follow-up. A tapered, titanium component is reliably placed into appropriate position and is forgiving as to varus implant position.