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

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.