Cement fixation of the femoral component in older patients.

Polymethylmethacrylate cement fixation of the femoral component in total hip arthroplasty is still a reasonable option in a select group of patients. Cement fixation is indicated in sedentary patients older than 75 years, certain older patients with rheumatoid arthritis, and patients with femoral neck fractures or conversion surgery. Hips with severe osteopenia or a "stove-pipe" femur (Dorr type C) may also be considered for cement fixation. The cemented femoral component should be fabricated of a cobalt-chromium alloy with a modern geometry and offset. Third-generation cementing techniques should be used to obtain a grade A or B cement mantle. Antibiotic cement may be used in patients at higher risk for infection. The 10-year results of cemented femoral components in these patient populations are excellent.