The modern surgeon has 3 key issues to consider,
- Whether to use a cemented prosthesis or a cementless prosthesis
- If a decision is made to go without cement, then he has to decide about the design (architecture) of stem he wishes to use
- Finally he has to choose the most suitable type of articulation for the patient he is about to treat. In this consideration he needs to take into account the patient’s age and physical expectations.
Issue #1 – Cemented versus Cementless
Cemented stems are highly successful for the less active and older patients provided modern, meticulous cementing techniques are employed. Cemented cups fare less well even with newer cementing techniques. Harris & Mulroy 1990) reported a loosening rate of 3% on the femoral side and 42% on the acetabular side at 10 years.
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