A comparison of cemented and cementless titanium femoral components used for primary total hip arthroplasty - A radiographic and survivorship study

Titanium has a low modulus of elasticity that makes it an attractive metal for femoral hip components. We directly compared 2 similar titanium stems, one cemented (n = 102 hips) and the other cetnentless (n = 7 8 hips), controlling for the most important surgical variables. The average radiographic follow-up was 6.7 and 7.0 years. Osteolysis below the joint line, zones 2 through 6, was 12.7%. (13 of 102) in the cemented group and 0% in the cementless group (P<.001). There were 17 acetabular revisions in each study group. The cementless group had no femoral revisions, whereas 9 acetabular revisions in the cemented group had a simultaneous femoral revision (P=.005). Survivorship, defined as revision of the femur, was 84% for the cemented group and 100% for the cementless group at 10 years. Cementless titanium stems are more resistant to osteolysis and mechanical failure compared with similar cemented titanium steps.