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Cemented versus cementless total hip arthroplasty. A critical review
1Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
Clinical Orthopaedics and Related Research
|May 1, 1990
Summary
Choosing between cemented and cementless fixation for total hip arthroplasty (THA) remains unclear. While cemented THA shows short-term success, uncemented THA offers improving long-term results, especially for younger patients.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Clinical Trials
Background:
- The optimal fixation method for total hip arthroplasty (THA) is a significant challenge for orthopedic surgeons.
- The decision regarding the use or omission of cement in THA remains debated, lacking definitive scientific consensus.
Purpose of the Study:
- To analyze the scientific process guiding the choice between cemented and cementless fixation in hip arthroplasty over the next decade.
- To provide a framework for evaluating clinical series addressing cemented versus uncemented hip fixation.
Main Methods:
- Review of theoretical advantages and disadvantages of cemented and cementless fixation in THA.
- Analysis of major clinical series and case reports pertinent to hip arthroplasty fixation outcomes.
- Evaluation of supporting data for both fixation techniques.
Main Results:
- Cemented primary THA demonstrates excellent short-term outcomes but shows deterioration over time.
- Uncemented primary THA yields satisfactory short-term results that tend to improve with time.
- Uncemented fixation is a rational choice for young, active male patients undergoing primary THA.
Conclusions:
- Cemented techniques are unsatisfactory for revision hip surgery.
- Uncemented techniques show promise for revision THA but require further validation.
- Long-term data favors uncemented fixation for primary total hip arthroplasty in select patient populations.