Cemented and Uncemented Total Hip Arthroplasty Using the Same Femoral ComponentMeding JB, Ritter MA, Davis KE, Hillery M.
The purpose of this study was to evaluate the same femoral component after cemented and uncemented total hip arthroplasty. The results were compared in terms of hip scores, subsidence, and survivorship.
Between 1986 and 1996, 1017 primary THAs were implanted in 882 patients using the same porous-coated, titanium-alloy, femoral component. 507 cemented stems (441 patients) and 510 uncemented stems (441 patients) were compared. The primary diagnosis was osteoarthritis in 866 hips (85%). 541 patients were female (61%). The clinical results were evaluated based on the Harris hip score. Radiographs were evaluated at each follow-up for stem subsidence and loosening. Kaplan-Meier survival analysis was used to determine stem survivorship. The average follow-up of the entire cohort was 13.2 years (range, 2-26 y).
The average Harris Hip Scores at 20 years follow-up was 87 points in the cemented group and 85 points in the uncemented group. Pain scores averaged 42 and 38 in the cemented and uncemented group, respectively, at 20 years. There were 6 loose stems identified in the cemented group (1.2%) and 2 loose stems in the uncemented group (0.4%). Cemented and uncemented stem survivorship at 20 years was 98.1% and 99.6%, respectively. There was no difference in cemented or uncemented stem survivorship at any time period.
Although there were more cases of aseptic cemented femoral component loosening, there was no significant difference in stem survivorship out to 20 years whether this stem was implanted with or without cement.