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The Journal of Bone and Joint Surgery, Vol 76, Issue 8 1121-1129, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
The prevalence of femoral osteolysis associated with components inserted with or without cement in total hip replacements. A retrospective matched-pair series
DD Goetz, EJ Smith and WH Harris
Orthopaedic Biomechanics Laboratory, Boston 02114.
The prevalence of femoral osteolysis in hips in which a femoral component
had been inserted without cement was compared with that in hips with a
cemented component, in a retrospective matched-pair study of the results of
primary total hip arthroplasties; all patients had received the same type
of acetabular component. Forty-one hips in thirty-nine patients who had a
Harris-Galante porous-coated total hip prosthesis without cement were
matched by age, sex, weight, duration of follow-up, and diagnosis with
forty-one hips in thirty-eight patients who had a hybrid total hip
reconstruction; the hybrid reconstruction consisted of the same acetabular
component and a Precoat femoral component inserted with a so-called
third-generation cementing technique. All of the operations were done by
the same surgeon, who used the same operative approach and the same course
of postoperative rehabilitation. All of the patients were followed for at
least four years (mean, six years). Osteolysis developed in twelve (29
percent) of the hips that had a femoral component without cement compared
with none of the hips that had a cemented component (p < 0.0002). At the
latest follow-up examination, none of the femoral components that had been
inserted with cement were loose and none had been revised, while eight (20
percent) of the femoral components that had been inserted without cement
were loose and five (12 per cent) had been revised. This retrospective
matched-pair study controlled for many of the variables associated with a
comparison of the rates of femoral osteolysis in separate series of femoral
components fixed with and without cement.(ABSTRACT TRUNCATED AT 250 WORDS)

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