Is diaphyseal stem fixation necessary for primary total hip arthroplasty in patients with osteoporotic bone (Class C bone)?

The purpose of this study was to determine the survivorship of the short, metaphyseal-fitting cementless anatomic stem, hip function, thigh pain, and the stress shielding after total hip arthroplasty in 72 patients (81 hips) with Class A bone, 73 patients (83 hips) with Class B bone, and 85 patients (92 hips) with Class C bone. Survival of the femoral stem at 7 years was similar for all 3 classes of bones (100%, 100%, and 98.2%, respectively). At 7 years after the operation, the mean Harris hip scores (95, 93, and 91 points, respectively), WOMAC scores (11, 12, and 15 points, respectively), incidence of thigh pain (none in all 3 groups), radiographic findings and bone mineral density were not significantly different among the 3 groups.