Hip replacement also known as Hip arthroplasty is the most effective surgical procedure to alleviate pain in the hip caused by chronic or severe arthritis. The surgery alleviates pain by replacing the damaged and worn out parts of the hip joint with artificial prosthetic components.
There are two techniques or ways by which artificial hip can be fixed to the bone while doing the surgery. Hip replacement can be thus be categorized into 2 types depending on the technique:
- Cemented Hip replacement
- Uncemented Hip replacement
Cemented and Uncemented Hip replacement
Though hip replacement is the best option for patients in severe pain due to arthritis, sickle cell, hip fracture or other diseases of the hip; one of the important thing that needs to be addressed while having hip replacement is- which technique is best to use- Cemented or Uncemented?
Cemented and Uncemented Hip prosthesis- The Difference
Irrespective of the type of Hip replacement surgery (Total or partial), the artificial hip joint comprises two basic components- one is the ball component made of highly polished strong ceramic or metal material, which is attached to the upper part of femur bone and the other is the socket component, cup shaped made of plastic, ceramic or metal and may have an outer shell made of metal which is attached to the acetabulum.
These components come in two different categories- Cemented and Uncemented which implies the method by which the components are to be fixed to your bone.
Cemented Hip prosthesis- It is designed to hold a layer of fast drying bone cement or a special glue usually polymethylmethacrylate (PMMA- an acrylic polymer) between the artificial joint and the existing bone. It secures the prosthesis to the natural bone.
Uncemented Hip Prosthesis- Uncemented prosthesis also known as press-fit prosthesis, hinge on the process named biologic fixation wherein the existing bone is allowed to grow and adhere naturally onto the specially textured component. It possess coarse surface and porous coating that fosters the naturally growing bone to fix snugly with the artificial prosthesis.
A combination of a cemented stem (femur) and uncemented socket may also be used for hip replacement which is often known as Hybrid Replacement.
Which one is better- Cemented or Uncemented Hip Replacement?
It is important to understand that choice of cemented or uncemented hip is unique for each individual. The decision depends on multiple factors including your age, quality and strength of your bone etc. Our top ranked orthopaedic surgeon in India will discuss and advice you the best plan after weighing the pros and cons in your case of choosing cemented or uncemented prosthesis.
Cemented vs Uncemented Hip replacement- Benefits and Drawbacks
Cemented hip prosthesis is generally considered to offer quicker recovery and significantly reduced post-operative pain. Moreover rehabilitation with full weight bearing can be commenced almost a day or two post-surgery.
However, cemented prosthesis may degrade over time and breakdown of the cement may occur causing loosening of the artificial hip joint which may need revision hip replacement surgery that may be more difficult to perform after cemented prosthesis is fitted.
On the other hand, the uncemented or press-fit hip prosthesis is believed to have extended recovery period as it takes time for the existing bone to grow naturally and secure the prosthesis. Patients are thus advised to avoid full weight bearing during initial weeks post-surgery. Such cautious approach decelerates the patient’s rehabilitation process.
However, the uncemented components tend to offer a long term and better adherence between the bones and prosthesis and also eliminate the apprehension of potential degradation and breakdown of the bone cement. Moreover, if necessary, performing revision hip replacement surgery in such case is easier than replacing a cemented hip prosthesis.
An analysis of the existing studies has shown that hip replacement with both cemented and uncemented prosthesis is equally successful with long term results. It concludes that the life of artificial hip is almost same with both type of hip replacement surgeries, of course, when the patient is properly chosen.
Nevertheless, the experienced orthopaedic surgeons often tend to use cemented prosthesis for the older and less active individuals having weak and porous bones (osteoporosis). In contrast, the uncemented prosthesis is most frequently earmarked for the younger ones who are active enough and who can well tolerate the extended rehabilitation period.
At any instance, it is important to understand that each individual’s case in distinct and the surgeon has to weigh the pros and cons in each case to decide the type of hip prosthesis that best suits your needs.
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