Although some early designs included femoral components fabricated from treated titanium alloy with a titanium alloy-polyethylene articulation, most femoral components are now fabricated from cobalt chrome for improved polyethylene wear and resistance to third body wear. Our choice for the porous coating is commercially pure titanium sintered to a cobalt chrome alloy substrate. This has been shown to provide excellent bone ingrowth.19 Our preference for the femoral component is a bimetal design, combining the superior wear properties of cobalt chrome with polyethylene, and the biocompatibility of titanium.20 This coating has an average pore size of 400 mm and a porosity of 55%, compared to a beaded surface porosity of about 35% regardless of bead size.
Porous-coated pegs and stems are avoided to minimize stress-shielding of the interface and improve bone preservation during revision. Porous-coated pegs may cause a starburst pattern of bone ingrowth, which stress shields the remaining interface and causes significant bone loss if revision is required.
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