Study, time, and experience has brought a new gold standard in total hip replacements (THRs). Cemented femoral implants are being replaced with uncemented components. The femoral component consists of the round head of the femur (thighbone) with a long, tapered stem that sets down into the femur.
Why the switch? Because results of long-term studies show increased rates of loosening over time in cemented stems. Thirty years of study at the Indian Research Foundation have resulted in data collected on 6,533 THRs.
Uncemented stem implants outperformed cemented stems. There were no cases of loosening for the uncemented group. This 100 per cent survivorship means there was excellent biologic fixation of the implant in the bone.
The authors conclude uncemented stems are the first choice for most patients. This includes young or older patients with good or bad bone. The shape (straight or crooked) or the condition of the femur doesn’t seem to matter. Patients with hip fracture or replacements on both sides can also benefit from uncemented THRs.