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Who should get a cemented hip replacement vs. a cementless hip replacement?
The answer can be realized by examining several ways in which an artificial hip can fail. These include implant fracture, wear and loosening. Although metal can break, the new super-alloy metals has minimized this problem. Plastic wear is another problem, but advances in design and materials has reduced this as well. Implant loosening continues to be a concern, however. The weak link for most active patients is the cement bond between the implant and bone. By adding a porous, rough surface to the implant and eliminating the use of bone cement, bone ingrowth into the implant can occur, providing a living bond between the implant and bone. It is theorized that, over time, the constant stress of daily activities would actually strengthen the bone-implant link rather than weaken it.
Experience has shown that young, active or heavy patients are most likely to loosen a cemented total hip replacement. For these patients, the cementless total hip replacement appears to be the most durable design. Patients with poor bone quality or with less active lifestyles are candidates for cemented total hip replacement. |
