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Cemented vs uncemented hip replacement: implications for operating theatre productivity
T Wainwright1,2, R Matzko1, T Immins1
1Orthopaedic Research Institute, Bournemouth University, UK.
Annals of the Royal College of Surgeons of England
|July 21, 2026
Summary
Uncemented hip replacements increase operating room efficiency, completing more procedures per list. This strategy can help the National Health Service (NHS) meet surgical targets and reduce patient wait times.
Area of Science:
- Orthopedic Surgery
- Health Services Research
Background:
- The UK's National Health Service (NHS) faces challenges meeting elective surgery recovery targets.
- Increasing operating theatre productivity is vital for reducing surgical waiting lists.
Purpose of the Study:
- To compare the efficiency of cemented versus uncemented total hip replacement (THR) procedures.
- To assess the impact of operating list delays on procedure completion rates.
Main Methods:
- Retrospective analysis of 236 cemented and 333 uncemented THR procedures (August 2007 - May 2009).
- Monte Carlo simulation to estimate the probability of completing four THR surgeries within an 8-hour list.
- Analysis included scenarios with 15- and 30-minute start delays.
Main Results:
- Uncemented THR procedures had a significantly higher probability (96%) of completing four cases in 8 hours compared to cemented (63%).
- Delayed starts reduced the completion probability for cemented THR more drastically than for uncemented THR.
- Mean surgical case times were 117.96 min for cemented and 101.54 min for uncemented prostheses.
Conclusions:
- Utilizing uncemented prostheses, when clinically appropriate, can enhance theatre throughput in the NHS.
- This approach may help maximize operating list capacity and address waiting times for elective surgery.