Options for primary femoral fixation in total hip arthroplasty. Cemented stems for all

In considering the subject of choices for the planning of femoral fixation in total hip arthroplasty, the strength behind the argument that cementing should be preferred in all ages and all conditions comes from three major positions, all supported by excellent data. First, the long term data (15-20 years) for well performed cemented stems are excellent and unmatched. Second, with good cementing techniques, the long term results in patients younger than 50 years of age are equal to the results in patients older than 50 years of age. No longer is there validity to the prior arguments that cementing does not work well in younger patients or that younger patients should have cementless femoral stems. Third, improvements in cementing technique have been shown in nationwide studies to produce statistically significantly better results than the original techniques.