Total hip Replacement was popularized by Sir John Charnley of England. He advocated Cemented total hip replacement. Total hip replacements with cement have a high success rate for over forty years. They are one of the most successful orthopedic procedures. In a cemented total hip replacement, both the acetabular and femoral components are cemented. Cemented hip replacement is the gold standard in elderly patients.
Cement helps to fill the crevices in osteopenic bones.
Advantages of cemented total hip replacement.
Patients can be mobilized full weight bearing immediately after surgery. As cement provides immediate fixation between the prosthesis and host bone, elderly patients can be mobilized immediately. Quicker mobilization can reduce morbidity and costs associated with hip replacement surgery. Survival rates of cemented hip replacements are quite favorable in the elderly population with about 90-95% survivorship at 10 year follow up. A successful outcome from a cemented hip replacement requires meticulous cementing technique. I use cement gun, femoral canal occlusion, vaccum mixing and pressurization to give a better result.
We perform cemented total hip replacements in elderly patients with primary osteo-arthritis. I use the CPT, Exeter and C stems for the femoral side. I use poly cups with flange. I started with cemented hip replacements in 1993 during my UK training. I have to my credit performed hundreds of hip replacements with cement.
The above x ray shows a cemented stem and uncemented socket.