The current status of acetabular fixation in total hip replacement

Aseptic loosening of the acetabular component is the major long-term complication of cemented total hip replacement. In this article, the improvements in cementing technique and cemented acetabular component design, as well as the evolution of noncemented acetabular cups, are reviewed. The porous-coated acetabular component has emerged as the state of the art in both primary and revision hip arthroplasty. Current trends in porous cup design and implantation are presented. The ultimate fate of the porous ingrowth cup will be based on long-term clinical and roentgenographic follow-up studies.