[Non-cemented alloplasty of the hip joint]

The authors present a review of the contemporary problem of non-cemented alloplasty of the hip joint. They compare the advantages and disadvantages of cemented and non-cemented endoprostheses of the hip joint in relation to possible loosening and possible re-operation and with regard to the surgical technique. The negative action of bone cement is divided into two groups: 1. immediate effects which act on surrounding tissues and the patient's organism during operation. 2. late effects which involve abrasion and the phagocytic response to small cement fragments and the formation of osteoaggressive granulations. These late effects are demonstrated on histological material. The authors emphasize that non-cemented alloplasty has also some pitfalls which involve in particular higher demands on the accuracy of the surgical technique and, no doubt, more severe haemorrhage. The main advantages are according to the authors the elimination of negative effects of bone cement, in particular late effects. The authors tried to classify the contemporary spectrum of available non-cemented implants with regard to their design, materials and surface finish.