Cemented Femoral Component Use in Hip Arthroplasty.

Elderly patients undergoing both elective and nonelective hip arthroplasty contribute markedly to health care spending, and the current aging population is likely to require even more resources. Several national joint replacement registries show a lower risk of revision surgery in patients older than 75 years who received cemented femoral components compared with cementless implants for primary total hip arthroplasty. Despite a higher incidence of early periprosthetic femoral fracture, noncemented femoral components are being used with increasing frequency in elderly patients worldwide. Improvements in cementing technique and modifications to cemented stem design over several decades allow surgeons to obtain femoral component fixation in poor-quality bone with a relatively low risk of complications. Achieving durable cemented stem fixation requires the surgeon to understand the basic handling properties of cement, how to prepare the femoral bone, and differences in stem design and surface finish.