214 primary total hip arthroplasties in 208 patients with the Müller straight stem using the second generation cementing technique were performed between 1979 and 1983. 149 hips were assessed clinically and 134 hips radiographically after a minimum of 10 years of follow-up. 55 patients had died and 10 hips had been revised, 4 for infection and 6 for aseptic loosening. In the remaining 139 patients the clinical results were very satisfactory (Merle d'Aubigné score). According to Harris’ radiographic and subsidence criteria there were 13.2% stem loosenings at 10 years. Stress shielding induced bone resorption of the proximal part of the femur was noted in 61.2% of the hips. Survival analysis of the stem showed a success rate at 10 years of 89.2% while the cumulative survival rate was 91.22% which compares well with the “gold standard” (Charnley's THA). It is suggested that there is a correlation between “physiological” subsidence and stress shielding induced bone resorption, which may lead to an elevated level of stem loosening after 10 years.
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