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Cementless, Cemented Hip Replacements Comparable

In those 55 and older, long-term survival of replacements found to be similar

THURSDAY, Oct. 16 (HealthDay News) -- Cementless and cemented total hip replacements showed similar long-term survival in patients aged 55 and older, researchers report in the October issue of the Journal of Bone & Joint Surgery.

Keijo T. Makela, M.D., of the Turku University Central Hospital in Turku, Finland, and colleagues analyzed data from 50,968 total hip replacements performed for primary osteoarthritis in Finnish patients aged 55 and older. They classified the implants in four groups: two cementless groups; a hybrid with a cemented stem and a modular, press-fit cup; and a cemented loaded-taper or composite-beam stem with an all-polyethylene cup.

The investigators found that cementless replacements, along with cementless stems and cups analyzed separately, had a lower risk of revision for aseptic loosening compared to cemented hip replacements in patients aged 55 to 74. Older patients showed no significant differences, aside from a reduced risk of revision for aseptic loosening of hydroxyapatite-coated cementless cups compared to cemented polyethylene cups. However, the high incidence of wear-related revisions of modular cementless cups points to a need for more wear-resistant articulations for cementless cups, the authors write.

"Our results suggest that cementless stems have better long-term resistance to aseptic loosening than do cemented stems in patients who are 55 to 74 years old. On the acetabular side, polyethylene wear, liner problems, and periprosthetic osteolysis are still major concerns. Biological fixation of implants seems to be a reliable option in all age groups," the authors conclude.

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