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Registry data show similar long-term results for cementless, cemented THRs
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Based on an analysis of 4,032 primary total hip arthroplasties in patients younger than 55 years, cementless stems and cups provided better long-term resistance to aseptic loosening than cemented implants. The risk for revision for any cause was the same regardless of fixation method.
Keijo T. Mäkelä, MD, referred to mid-term results of studies that showed better survival of cementless stems for aseptic loosening in young patients with primary osteoarthritis. “However, it has not been clear if the survival against aseptic loosening of cementless cups is comparable to that of cemented cups,” he said at the 2010 EFORT Congress.
The researchers accessed the Finnish Arthroplasty Register long-term survival rates of cemented and cementless total hip arthroplasties.
Patients were classified according to implant/fixation type: cementless group 1 included patients whose implants had a cementless, straight, proximally circumferentially porous-coated stem and a porous-coated press-fit cup; cementless group 2 included patients whose implants had a cementless, anatomic, proximally circumferentially porous-coated and/or hydroxyapatite-coated stem with a porous-coated and/or hydroxyapatite-coated press-fit cup; and the cemented group included patients whose implants had a cemented stem combined with a cemented all-polyethylene cup.
Both cementless groups showed significantly reduced risk of revision for aseptic loosening compared with the cemented group. The 15-year survivorship of cementless stem groups 1 and 2 for aseptic loosening was higher than that of the cemented group (89% and 90% vs. 72%), and the 15-year survivorship among patients with cementless press-fit porous-coated cups for aseptic loosening was higher than that of patients with cemented cups (80% vs. 71%), Mäkelä reported.
“Even if liner-exchange revisions are taken into account, the long-term survival of cementless total hip replacements is comparable to that of cemented implants,” they concluded in their abstract. – by Thomas M. Springer
Reference:
- Mäkelä K, Eskelinen A, Pulkkinen P, et al. Long-term results of 4,032 primary total hip replacements for primary osteoarthritis in younger patients from the Finnish Arthroplasty Register. Paper F7. Presented at the 2010 EFORT Congress. June 2-5, 2010. Madrid.
- Keijo T. Mäkelä, MD, can be reached at keijo.Mäkelä@tyks.fi.
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