Cemented femoral fixation: the North Atlantic divide.

There is a North Atlantic divide, with cementless femoral stems being used more frequently in the USA and cemented stems being used more frequently in many countries in Europe. This is primarily because different cemented stems have been used on different sides of the Atlantic and the results of the cemented stems in the US have often been poor, whereas the results of the stems used in Europe have been good. In the National registers in Europe, cemented stems have tended to achieve better results than cementless.