The tapered press fit total hip arthroplasty: a European alternative.

The tapered rectangular press fit femoral component design of Karl Zweymüller remains highly successful since its inception in 1979. The longitudinal taper and rectangular cross-section provide unequaled primary stability, which promotes consistent secondary osseointegration to the grit-blasted titanium surface, even in osteoporotic bone. The "fit without fill" concept provides for bone conservation and preservation of the intraosseous blood supply by compaction, rather than removal, of the metaphyseal cancellous bone. The surgical technique is simple and forgiving, allowing for infinite adjustability in stem height and anteversion. Numerous long-term studies report excellent clinical results with a negligible incidence of loosening, thigh pain, osteolysis, or significant stress shielding and survivorships approaching 100% at 10 years.