Twenty-Five- to Twenty-Seven-Year Results of a Cemented vs a Cementless Stem in the Same Patients Younger Than 50 Years of Age

Abstract

Background: No study to our knowledge evaluated the long-term survivorship of the contemporary cemented vs cementless stems more than 25 years of follow-up in the same patients younger than 50 years of age. Purpose of Study: The purpose of the study is to determine (1) validated outcome scores, (2) prevalence of polyethylene wear and osteolysis, and (3) survivorship of the cemented vs cementless femoral components in the same young patients at minimum follow-up of 25 years. Methods: We report 171 patients (mean age, 47.7 years) at the time of the surgery who received simultaneous bilateral total hip arthroplasty with a cemented stem in one hip and a cementless stem in the other (26.1-year follow-up). A cementless acetabular component was used in all hips. There were 125 men and 46 women. The mean age at the time of the arthroplasty was 47.7 +/- 10.7 years (range, 21-50 years). Results: The average Harris hip scores were similar between the groups of cemented stem (mean, 91 points) and cementless stem (93 points). Survival rate of the acetabular component (79% vs 78%) and that of the femoral component (96% vs 95%) at 26.1 years were similar between the 2 groups. Conclusions: The long-term fixation of the acetabular metallic shell and cemented or cementless femoral stem was outstanding. Polyethylene wear and periacetabular osteolysis were contributing factors to reduce the long-term survival of the contemporary total hip arthroplasties with or without cement in young patients. New bearing surfaces such as ceramic on ceramic or ceramic on highly cross-linked polyethylene would improve wear of the bearing surfaces. (C) 2016 Elsevier Inc. All rights reserved.