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 cementless (n = 78 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 stems. Copyright 2002, Elsevier Science (USA). All rights reserved.