Cemented versus Cementless Total Hip Arthroplasty: A Comparative Study

Abstract

Background: Total hip arthroplasty (THA) is a well-established procedure for treating end-stage hip disorders. However, controversy remains regarding the optimal fixation method cemented or cementless especially concerning functional outcomes, complication rates, and implant survival.
Objective: To compare clinical, functional, and radiological outcomes of cemented versus cementless THA in a Retrospective study. Methods: A Retrospective comparative study of 32 patients undergoing primary THA between May 2020 and December 2023. Patients were divided into two groups: cemented THA (n = 14) and cementless THA (n = 18). Clinical outcomes were assessed using the Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) preoperatively and at 6 and 12 months postoperatively. Radiological assessment included component positioning, loosening, and subsidence. Perioperative complications and revision rates were recorded.
Results: Both groups demonstrated significant improvements in functional scores at 6 and 12 months (p < 0.001). At 12 months, the cementless group had a statistically higher mean HHS (89.2 ± 6.3) compared to the cemented group (86.4 ± 6.9) (p < 0.05). Radiological stability was achieved in 96% of cementless and 92% of cemented implants. The cemented group had a higher rate of early medical complications, whereas intraoperative femoral fractures occurred only in the cementless group (4%).
Conclusion: Both cemented and cementless THA produce excellent short-term outcomes. Cementless fixation demonstrated slightly superior functional results, while cemented THA remains a reliable option for patients with compromised bone quality. Long-term follow-up is needed to assess implant survival.