Cemented vs. Uncemented Hip Replacement: Which Is Better?

Breakthrough In Medical Imaging For Use In Hip Replacements. David Silverman / GettyImages

When you're planning to get a hip replacement, you and your doctor will need to decide whether to use a cemented or uncemented artificial hip joint.

The difference is just what the names suggest — in a cemented artificial hip joint (known in medical terms as a prosthesis), a type of cement is used to secure the artificial hip joint. Meanwhile, in an uncemented prosthesis, the artificial hip is eventually secured by the growth of your bone into the artificial hip joint.

There are pros and cons for each approach, and your answer to the question "which is best?" will depend on your age, your level of fitness, and your overall health status. As you're discussing the surgery, you should talk with your doctor about what she recommends and the reasons behind her recommendation for you.

Whats the Difference Between Cemented and Uncemented Artificial Hips?

It's generally believed that with a cemented prosthesis, recovery is quicker (because the hip is secured immediately), there's less post-operative pain, and most importantly, rehabilitation can be started almost at once. However, a cemented prosthesis, in theory, might not last as long as an uncemented one, and a second hip replacement, if necessary, might be somewhat more difficult.

The uncemented hip prosthesis is thought to last longer, and a subsequent hip replacement might be somewhat easier to perform than when replacing a cemented prosthesis.

The major disadvantage with an uncemented hip prosthesis is that waiting for bone growth to secure the hip (up to three months) slows the rehabilitation process. Post-operative pain is also more of a problem with an uncemented artificial hip.

Which Patients Should Get Which Type of Hip Prosthesis?

In general, surgeons have tended to reserve the uncemented prosthesis for relatively young patients, who are more likely to need a second hip prosthesis down the road, and for whom a longer rehab period might be somewhat easier.

For the majority of older patients (and many younger ones), surgeons recommend the cemented prosthesis. Cemented artificial joints may also work best for people who have osteoporosis or weakened bones.

An analysis of the available studies on this topic, published in 2013, concluded that long-term results were quite similar with cemented and cementless artificial hips. That is, the data strongly suggested that the length of survival (of both the hips and the patients) were actually quite similar with both types of hip replacement.

This study also confirmed that recovery from surgery was quicker with the cemented prostheses. So, apparently, the advantages to the cementless prosthesis may be less real than has been supposed.

In any case, each person's condition is unique, and you and your doctor must weigh the advantages and disadvantages in each case to decide which type of prosthesis is better in your situation.

Sources:

Abdulkarim A, Ellanti P, Motterlini N, et al. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials. Orthop Rev (Pavia). 2013 Feb 22; 5(1): e8. Published online 2013 Mar 15. doi: 10.4081/or.2013.e8 PMCID: PMC3662257

(Edited by Richard N. Fogoros, MD)

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