CONCERNS AND IMPROVEMENTS WITH CEMENTLESS METAL-BACKED ACETABULAR COMPONENTS

The relatively high incidence of acetabular component failure shown in long-term followup studies of cemented total hip replacement has led to the use of noncemented fixation on the acetabular side of the total hip arthroplasty. In the first generation of noncemented acetabular d evices, large-size femoral heads requiring thinner polyethylene were u sed with many of the popular designs, These components were also modul ar, but the design considerations involved in minimizing polyethylene debris were not fully appreciated, The newer designs of noncemented ac etabular components are addressing the need to minimize wear and the p roduction of particulate debris at the bearing surface and metal-polye thylene interface, Newer techniques also have been developed to provid e initial component stability and bone-prosthesis contact, With these improvements, the results of noncemented acetabular fixation may outpe rform the results with cemented fixation. This may be especially true when considering the ease of insertion and versatility of noncemented acetabular components.