Cemented versus uncemented femoral component total hip arthroplasty in elderly patients with primary osteoporosis: retrospective analysis with 5-year follow-up

Abstract

Objective

To compare medium-term clinical and radiological outcomes of primary unilateral uncemented (UN) or cemented (CE) femoral component total hip arthroplasty (THA) in elderly patients with osteoporosis.

Methods

Consecutive patients with osteoporosis who underwent primary unilateral UN or CE THAs at our institution from 2006 to 2013 were retrospectively reviewed. All consecutive procedures were managed by high-volume surgeons, using UN or CE THA approaches. Follow-up assessments occurred at 1, 3, 6, 9, and 12 months postoperatively, and yearly thereafter. Patient-related functional outcomes were assessed using the Harris Hip Score (HHS). Primary and secondary endpoints were early revision (<5 years) and functional outcome.

Results

In total, 496 primary unilateral THAs (CE, n = 184; UN, n = 182) were assessed with a median follow-up period of 75 months (range, 65–86 months). From 3 months after surgery to the final follow-up, HHS was consistently superior in the CE group. Respective prosthetic loosening rates in the UN and CE groups were 26.4% and 16.8% at a minimum of 5 years. There was a significant difference in rate of early revision (7.6% CE vs. 14.8% UN).

Conclusion

Compared with UN THA, CE THA exhibits a superior outcome in elderly patients with primary osteoporosis.