THE ANDRY,NICOLAS AWARD - COMPARATIVE RESULTS OF CEMENTED AND CEMENTLESS TOTAL HIP-ARTHROPLASTY

A prospective randomized clinical trial comparing cemented to cementle ss total hip arthroplasty has been ongoing at the author's institution since 1987, All parameters assessed showed that there was no statisti cally significant difference in any of the health related quality of l ife measures used when patients with cement were compared with patient s without cement at any of the followup periods as many as 4 years lat er, The improvement was dramatic and sustained, No components (cemente d or cementless) have been revised to date (average, 4.8 years), A rad iographic analysis showed probable loosening of the cemented socket in 24% and presumed minimal pelvic osteolysis in 8%. The cementless sock ets showed a greater frequency and severity of pelvic osteolysis (14%) , The cemented femoral component was judged to be possibly loose in 10 %; however, none were considered probably loose, The patients who had cementless femoral components were doing extremely well with the compo nents showing very little subsidence or proximal stress protection not ed, Osteolysis on the femoral side was not seen in any of the cementle ss stems, Total hip replacement gives comparable clinical results when health related quality of life measures are analyzed; however, metal backed cemented acetabular components have a high rate of radiographic failure, Short-term stability of a noncemented porous coated titanium stem, however, gave excellent clinical and radiographic results.