Cemented and uncemented total hip arthroplasty using the same femoral component

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint degeneration.
• Femoral component fixation, either cemented or uncemented, is a critical factor in THA success.
• Long-term outcomes comparing cemented and uncemented fixation for the same femoral component are essential for clinical decision-making.

Purpose of the Study:

• To compare the clinical outcomes, specifically hip scores, stem subsidence, and survivorship, of a single porous-coated, titanium-alloy femoral component when implanted using cemented versus uncemented techniques.
• To evaluate the long-term performance of cemented versus uncemented femoral stems in primary total hip arthroplasty.

Main Methods:

• A retrospective study comparing 507 cemented and 510 uncemented femoral stems implanted between 1986 and 1996.
• Evaluation of Harris hip scores for clinical outcomes and radiographic assessment for stem subsidence and loosening.
• Kaplan-Meier survival analysis was employed to determine stem survivorship over an average follow-up of 13.2 years (range, 2-26 years).

Main Results:

• At 20 years, average Harris Hip Scores were 87 for cemented and 85 for uncemented stems.
• Pain scores at 20 years were 42 (cemented) and 38 (uncemented).
• Stem survivorship at 20 years was 98.1% for cemented and 99.6% for uncemented, with no statistically significant difference observed between the groups at any time point.

Conclusions:

• Despite a higher incidence of aseptic loosening in cemented femoral components, there was no significant difference in stem survivorship between cemented and uncemented fixation up to 20 years post-THA.
• The choice between cemented and uncemented fixation for this specific femoral component did not impact long-term stem survival.