The purpose of this study was to substantiate the continued use of a cementless plasma-sprayed, proximal-to-distal dual-tapered-geometry femoral-component design on the basis of long-term clinical and radiographic evidence. This justification is particularly pertinent in cementless total hip arthroplasty, in which bone-stock preservation and prosthetic-host compatibility are essential. A series of 101 patients managed with 120 primary arthroplasties who had a minimum follow-up of ten years was retrospectively reviewed. A meta-analysis of published reports of cementless tapered femoral components with a minimum follow-up of five years then was performed to validate the results of this review. At a mean follow-up of 12.2 years, a mean 38-point improvement in the Harris hip score was observed. Thigh pain was mild or absent after 97.5% (117) of the 120 arthroplasties. Distal femoral osteolysis was observed after 1.7% (two). Three femoral components had been revised secondary to aseptic loosening, yielding a 97.5% survivorship.