Abstract
Cement is the commonest method used to fix femoral components in the UK. This is not surprising as in the UK cemented fixation has provided better results than cementless fixation. The results of cemented fixation do however depend on the design of the stem. Polished collarless tapered stems are now the most widely used stems in the UK. These stems subside within the cement mantle thus compressing the cement and cement-bone interface and preventing these from failing. They are thus very tolerant of poor quality cementing. As a result aseptic loosening is extraordinarily rare even in young active patients. Compared with cementless fixation cement is very forgiving. It can be used with ease whatever the anatomy of the proximal femur and whatever the bone quality. Correct leg length can also easily be achieved. Thigh pain does not occur and intra-operative fractures are very rare. The antibiotics in the cement decrease the incidence of infection. In addition cement provides an effective barrier to particulate debris and joint fluid under pressure. The only real disadvantage of cemented fixation is that it may take longer than cementless fixation. However this extra time spent is compensated by the cheaper implant costs.
