Changes in bone mineral density (BMD) at the proximal femur were evaluated in 83 cemented total hip arthroplasties (THAs) 5 years after surgery. The BMD changes were compared among 5 stem designs and were related to the stem migration. A greater BMD decrease was found in Scientific Hip Prosthesis (Biomet, Bridgend, UK) and SPII CoCr stems (Link, Hamburg, Germany) than in Exeter (Howmedica, London, UK), Spectron (Smith & Nephew, Memphis, Tenn), and SPII Titanium stems (P < .05), and the stiffer SPII CoCr stems (Link) had a larger bone loss than the SPII Titanium stems (Link). However, no overall relationship was found between the BMD changes and stem migration or stem stiffness.