Panichkul P, et al. - Two hundred and ten total hip arthroplasties (in 193 patients) performed between 1996 and 1999 were assessed by the experts in order to evaluate the long-term clinical and radiological outcomes of a proximal porous-coated, dual-offset, tapered titanium alloy uncemented stem at least of 15 years of follow-up. The average follow-up as observed was 16 years. At 16 years, Kaplan-Meier survival analysis with revision of stem for aseptic mechanical loosening (one stem) as the end point exhibited a cumulative survival rate of 99.5%. From the pre-operative period to the latest follow-up, the Harris Hip Score, Western Ontario and McMaster University Arthritis Index, and the Short Form Health Survey-12 Physical scores were all markedly enhanced. Minor osteolysis was seen proximally in 14 hips with no osteolysis distal to the porous coating. Hence, this study described the largest series reporting the most lasting clinical follow-up of the third-generation dual-offset proximal in-growth, tapered cementless stem. Moreover, at a minimum of 15 years follow-up, the Synergy^TM stem design accomplished outstanding clinical outcomes, predictable osteointegration, and excellent survivorship of 99.5%, outlining the standard for femoral stems at expert's institution.