Abstract
Recent advancements in biomaterial technology have created novel options for acetabular fixation in primary total hip arthroplasty (THA). For example, cementless acetabular fixation has become the preferred option, however, there is continued debate concerning whether long-term survivorship is comparable to that of cemented component fixation. Many doubts previously associated with early cementless designs have been addressed with newer features such as improved locking mechanisms, enhanced congruity between the acetabular liner and the shell, and the inclusion of highly cross-linked ultra-high molecular weight polyethylene (UHMWPE). Additionally, there has been increased utilization of new porous metals, titanium mesh, and hydroxyapatite (HA) coated implants. However, several retrieval studies have indicated that porous-coated cementless acetabular components can exhibit poor bony ingrowth. Many surgeons in Europe favor cemented fixation, where registry data is favorable for this interface. A surgeon's decision to use a cemented or cementless acetabular component is typically dependent on factors such as patient bone stock, surgical training, and experience. With the frequency of THAs expected to increase, it is particularly important for orthopaedic surgeons to be familiar with appropriate preoperative planning and component selection in an effort to achieve optimal outcomes. Therefore, this talk will outline and describe the options currently available for cementless and cemented acetabular fixation in primary total hip arthroplasty.
