OSTEOLYSIS IN CEMENTED VERSUS CEMENTLESS ACETABULAR COMPONENTS

A prospective, randomized, double-blind, clinical trial comparing ceme nted with cementless total hip arthroplasty was performed to compare t he prevalence and pattern of acetabular osteolysis. Both groups were s imilar before surgery. Acetabular components were metal-backed, titani um implants. Twenty-eight-millimeter modular femoral heads with titani um femoral stems were used. At a minimum 2-year and mean 4-year follow -up period (range, 2-6 years), 224 patients had clinical and radiograp hic data available. There was no significant difference in the prevale nce of acetabular osteolysis between cemented (5%) and cementless (9%) fixation. With or without cement, the use of a titanium femoral head led to osteolysis within a relatively short period after surgery in al most all of the cases, although this was not significant. The pattern of acetabular osteolysis was different. Progressive osteolysis occurre d predominantly in acetabular zone 1 in the cemented group and zone 2 in the cementless group. Cementless fixation of acetabular components has been advocated in an attempt to minimize osteolysis that may occur in cemented total hip arthroplasty. This study found no difference in the prevalence of acetabular osteolysis between the two groups.