We are trying to help Dad navigate his upcoming hip surgery. The surgeon is suggesting going with a cemented implant. They are only doing a half-joint replacement. We understand the two options are cemented versus cementless. What's best?
Many studies have been done comparing these two approaches when putting in a partial hip replacement. This type of implant is called a hemiarthroplasty. Although there are pros and cons to both, the results are more favorable for cemented fixation. The studies were focused on the femoral head, neck, and stem portion of the implant.
Patients receiving a cemented hemiarthroplasty had less thigh pain, faster recovery, and better overall function. Patients with cementless stems required the use of a walking aid (walker, cane, crutches) more often when compared with cemented implants.
The final outcome was higher patient satisfaction among the cemented group. There have been reports of fracture around the implant when cementless components were used. Patients who received the cementless type were older, so age may be a factor.
Surgeon preference and experience are also important. Results are likely to be better when the surgeon works with what is familiar and comfortable. Take your cues from him or her. Unless there are medical reasons to go with a cementless implant, follow the recommendation made by your surgeon.
Ryan G. Miyamoto, MD, et al. Surgical Management of Hip Fractures: An Evidence-Based Review of the Literature. I: Femoral Neck Fractures. In Journal of the American Academy of Orthopaedic Surgeons. October 2008. Vol. 16. No. 10. Pp. 596-607.
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