There are a number of different ways that a hip replacement procedure can be performed, but at a very basic level, there are two main ways that the new artificial joint can be secured in place, with a cemented or an uncemented procedure. The cemented replacement was popularized in the 1960s and quickly became the standard practice, but as medical technology has progressed and improved techniques have been developed, today the vast majority of hip replacements are conducted using the uncemented method. In today’s blog, we talk about the two different techniques and explore the benefits and drawbacks of cemented versus uncemented hip replacement.
Cemented Or Uncemented Hip Replacement
These two hip replacement techniques differ in how the prosthetic implant is fixed to the remaining natural bone in the area. Before we dive into the benefits of each procedure and which patients may be best suited for a certain technique, let’s explain each style in greater detailed:
- Cemented Hip Replacement – During a cemented hip replacement procedure, the surgeon uses bone cement to secure the artificial implant to the surface of the bone. This bone cement becomes a grout-like substance that secures the implant by acting as an interlocking surface between the implant and the bone. As cement component materials have improved, so too has the ability to achieve an incredibly strong and secure fixation, and this bone cement can harden in as little as 10 minutes.
- Uncemented Hip Replacement – An uncemented hip replacement uses prosthetic components that are specifically designed in such a way to ensure implant fixation. During the procedure, the artificial femoral component is typically covered with a porous surface that has microscopic contours and ridges. This design ensures that natural bone grows on, in and around the porous surface, effectively creating a mesh gridlock that secures the implant to the bone.
Both techniques create an environment where the new artificial implant can fuse with the remaining hip bone to restore function and mobility. But which technique is right for you?
Benefits Of Cemented Vs. Uncemented Hip Replacement
As we mentioned above, the uncemented procedure is considered the current standard technique in the US, and estimates suggest that roughly 90 percent of hip replacement procedures use an uncemented technique. The main reason for this is because it creates a more natural healing plane that avoids some of the potential issues associated with the cemented technique. Bone cement is more likely to break or to irritate the soft tissues around the area, leading to the onset of uncomfortable inflammation. These two factors, along with repetitive stress on the cemented joint, led to the possibility of implant loosening, which would require additional treatment.
Uncemented hip replacements are much less likely to lead to the same issues, as the connection between the artificial hip and the remaining bone occurs through a more natural healing process. This can also lead to more natural movement and an expanded range of motion compared to a cemented procedure. While this is ideal, the main issue with an uncemented fixation is that this healing process takes much longer than a cemented correction. Cemented implant fixation is practically instantaneous, whereas the uncemented technique takes at least three months for a strong fixation to take place. That’s not to say that total recovery is instantaneously with a cemented technique, but weight bearing typically occurs much sooner.
With that said, let’s take a closer look at who may be an ideal candidate for cemented and uncemented hip replacements.
Uncemented Hip Replacement Candidates:
- Younger
- Healthier
- Active/Desire To Stay Active
- Hip Joint Less Affected By Osteoporosis
Cemented Hip Replacement Candidates:
- Older
- Underlying Health Issues
- Inactive/Mobility Restrictions
- Osteopenic Or Osteoporotic Hip Bones
- Those Who’d Benefit From Faster Implant Fixation
Although individual factors will vary, both cemented and uncemented fixations have a very long expected shelf life, meaning it’s highly unlikely that you’ll need to have a second procedure due to hardware degeneration regardless of the technique you choose.
For more information about either technique, or to consult with a hip specialist about new or chronic hip symptoms you’re experiencing, reach out to Dr. Botero and his team today at (865) 558-4444.
