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Background There is a relatively high failure rate of the femoral component in patients with avascuiar necrosis at the intermediate-term follow-up.Improving the geometrical fit of the femoral stem against the medullary canal may help to provide long-term survivorship of the hip replacement for patients with avascular necrosis.Methods We designed a specific stem,based on morphometric studies of proximal femoral canals in Chinese avascular necrosis patients and evaluated the stem by finite element analyses,comparing the novel stem with two commercially available and commonly used stems.Results The morphometric data from avascular necrosis patients showed specific geometric differences in the proximal femoral canal,including profile curves in both the sagittal and coronary planes than the patients with femoral neck fracture.The shorter stemmed prostheses (Fitmore(R) and our stem) performed better than the longer stemmed prosthesis (VerSys(R)).Conclusions This is the first study to investigate the femoral geometries of Chinese avascular necrosis patients.Our stem provides better stability and is theoretically beneficial to bone ingrowth,which may increase the long-term stability and fixation of the implant.