Abstract
Fixation of cemented femoral stems is reproducible and provides excellent early recovery of hip function in patients 60–80 years old. The durability of fixation has been evaluated up to 20 years with 90% survivorship. The mode of failure of fixation of cemented total hip arthroplasty is multi-factorial; however, good cementing techniques and reduction of polyethylene wear have been shown to reduce its incidence. The importance of surface roughness for durability of fixation is controversial. This presentation will describe my personal experience with the cemented femoral stem over 30 years with 3 designs and surface roughness (RA) ranging from 30 to 150 microinches.
Results
Since 1978, three series of cemented THA have been prospectively followed using periodic clinical and radiographic evaluations. All procedures were performed by the author using the posterior approach. Excellent results and Kaplan-Meier survivorship ranges from 90% to 99.5% in the best case scenario were noted at 10 to 20 year follow-up.
Conclusion
With a properly-designed femoral stem, good cement technique, proper cement mantle, and surface roughness of 30 to 40 microinches, the cemented femoral stem provides a durable hip replacement in patients 60 to 80 years old with up to 95% survivorship at 10 to 20 year follow-up.
