To cement or not to cement acetabular cups in total hip arthroplasty: a systematic review and re-evaluation

Introduction : Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods...

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Bibliographic Details
Published inSICOT-J Vol. 5; p. 35
Main Authors Van Praet, Frank, Mulier, Michiel
Format Journal Article
LanguageEnglish
Published Les Ulis EDP Sciences 2019
Subjects
Age
Arthritis
Cement
Cemented versus hybrid
Cost
Functionality
Hip
Joint replacement surgery
Joint surgery
Medical prognosis
Patients
Polyethylene
Prostheses
Review
Revision rate
Studies
Systematic review
Total hip arthroplasty
Europe
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Summary:Introduction : Total Hip Arthroplasty (THA) in the treatment of primary osteoarthritis of the hip has evolved to a very safe and cost-effective intervention with revision rates below 5% after 10 years. To this day, however, controversy remains on whether or not to cement the acetabular cup. Methods : A comprehensive PubMed search of the English literature for studies published between 2007 and 2018 was performed. Studies comparing the clinical (revision rate, functionality), radiological (wear) or economic (cost) differences between cemented (cemented stem with cemented cup) and hybrid (cemented stem with uncemented cup) prostheses for primary osteoarthritis of the hip were identified as eligible. Results : A total of 1032 studies were identified whereof twelve were included for qualitative synthesis. All studies concerning the risk of revision were based on registry data, covering a total of 365,693 cups. Cemented prostheses had a similar or lower risk of revision compared to hybrid prostheses in every study, but performed slightly worse on functionality and quality of life. While cemented prostheses were the cheapest option, hybrids were the most cost-effective. Discussion : The widespread preference for cementless fixation of the acetabulum cannot be explained by a superior survival of cementless or hybrid models. Irrespective of age, cemented fixation of the acetabulum remains the gold standard to which other techniques should be compared.
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ISSN:2426-8887
2426-8887
DOI:10.1051/sicotj/2019032