Abstract
Introduction: Over the last 37 years I have performed more than 8000 primary and revision THRs. These include cemented, hybrid, and noncemented types of fixation. There are many preventable complications which include: infection, delayed wound healing, perforation or varus position of the implant, and suboptimal cement technique. Quality of function depends on restoring center of rotation, restoring offset, equal limb length, balancing soft tissue, and adequate pain control. Long-term success depends on durable fixation and reduced wear. Cement fixation into cortico-cancellous bone provides durable fixation.
Discussion: We have a cohort at my practice of 370 total hip replacements. Fifty-three percent were cemented, 25% were hybrid, and 22% were noncemented. In another cohort of 253 cemented THR followed for a 10-year period, only two failures were found. One revision was for dislocation and the other was for loosening. I have found the Interlock system to have a very successful survivorship rate. I believe the reason for superior results is better polyethylene, better patient selection, and better surgical technique. I indicate cemented fixation for patients 60 years and older. I avoid if there is excessive bleeding and in a heavy, active patient.
