Nahhas CR, et al. - Researchers evaluate mid-term survivorship of total hip arthoplasties (THAs) using a cementless modular system via reviewing 221 patients who underwent a primary THA using the ALFA II modular stem (Encore Medical, Austin, Texas) by a single surgeon between 2002 and 2004 were reviewed. Death of 28 (12.7%) patients from causes unrelated to the surgery prior to adequate follow-up and lost to follow-up for 64 (29.0%) patients, left 129 patients for analysis. At a mean 6.5 year follow up, all-cause survivorship of the modular stem system was 81%. In view of a high failure rate of the modular stem hip system at mid-term follow-up, they suggest practicing caution against the use of similar designs in primary THAs.