[Fixation of endoprostheses with or without cement?].

The question of anchoring endoprostheses with or without cement is approached by analysing the following parameters: Frequency of application, costs, current medical and technological development, difficulty and duration of surgical procedure, acceptance by the tissues (seen from the aspects of Biomaterials, Biomechanics and Biology) and longstanding clinical results of the respective devices. Yet the majority of these parameters did not allow a clear decision. Only the correlation between implant and tissue provided some interesting hints: Since bone cement guarantees immediate primary stability it is qualified especially for anchoring endoprostheses in patients who will put weight on their artificial joint right after the implantation. A fixation without bone cement could be favoured if new formation and preservation of bone have priority over primary stability. From this derives the following recommendation for practical purposes: Endoprosthetic components should be anchored without cement in patients younger than 70 and in revisions, while bone cement may be used in patients over the age 70.