[Show abstract][Hide abstract] ABSTRACT: This prospective study was conducted on 108 consecutive implantations straight, cementless, taper-designed stem with variable lateral flare (Pegasus; DePuy, Warsaw, Indiana) at an 8- to 10-year follow-up; DEXA scanning was performed at 3 and 12 months on a second cohort of 40 patients. The mean Harris hip score was 94.2, and no revision was performed. Measurable subsidence of the stem was found in three (2.8%) patients; the subsidence was always measured within the first year of follow-up, and did not progress at the subsequent controls. Bone mineral density decreased at 1 year, 15.1% in zone 1 and 3.4% in zone 7. Uncemented stems with a taper design, which provide a high metaphyseal fit and a low diaphyseal fit, lead to comparable and reproducible long-term results independently from other design characteristics.