Introduction: Our aim is to study the morphological changes (and related factors) that occur in the proximal femur in patients with THR with a minimum 10 year follow-up.

Materials and methods: We have included 50 THRs carried out between October 1992 and June 1995 with porous stems with metaphyseal support proximally coated with hydroxyapatite. Changes in the morphology and density of the proximal femur and its relationship with several factors, especially polyethylene wear, were carried out by means of a series of x-rays taken during the whole period of evolution and a spiral CT taken during the last review.

Results: There was no subsidence, stem migrations or femoral revision surgery. After one year, all patients show an sclerotic region in the area of metaphyseal support that remains stable throughout the study period. During this period, only two other types of changes were seen in the proximal area.

lytic areas surrounded by a halo of sclerosis in the greater trochanter (in 18 cases they were very small and in 14 cases of a greater size). These areas were statistically significantly related to a greater rate of wear;

Conclusions: The metaphyseal area of the stem continued to comply with its support function during the period studied. In more than half of the cases there was some sort of bone loss in the proximal area. There is a relationship between polyethylene wear and the appearance of areas of lysis in the trochanter.

Background: Measurement of quality of life (QOL) and functional status provides important additional information for priority setting in health policy formulation and resource allocation. Our aim was to define the differences in the health-related quality of life between hip artroplasties with cementation and without cementation. The last objective was to reunite evidences on the advantages and disadvantages of both systems of hip arthroplasty fixation. Methods: We analyzed a random sample of patients in surgical waiting list of total hip arthroplasty, between 65 and 75 years, divided in two groups of 40 patients who received a cemented or uncemented THA, respectively. We compared the pre-operative characteristics and at a year after operation changes in the Nottingham Health Profile (NHP) and SF-12 self-administered questionnaires. We also performed the specific Harris hip score. To make the different scoring systems comparable, all scores were transformed to a 0-to 100-point scale, with 100 points indicating best health. Differences among these groups were compared using the Mann-Whitney U test. Results: All patients increased their QOL scores. Both groups had similar QOL scores before surgery. At 1 year, patients with the uncemented prosthesis had slightly higher scores for energy, pain, and emotional reaction. Changes in QOL scores were, however, very similar. Conclusions: The use of an uncemented prosthesis does not impair early outcome.