Volume 9 Number 1 2025
Comparative Analysis of Cemented vs. Uncemented Hip Prostheses in Elderly Bangladeshi Patients with Osteoarthritis
Mohammad Sazzad Hossain1*, Erfanul Huq Siddiqui2, Sharif Md. Musa1, Shaik Forhad1
Integrative Biomedical Research (Journal of Angiotherapy) 8(7) 1-8 https://doi.org/10.25163/angiotherapy.8710295
Submitted: 14 May 2024 Revised: 01 July 2024 Published: 02 July 2024
Abstract
Background: Total Hip Arthroplasty (THA) is a widely accepted treatment for end-stage hip osteoarthritis (OA), particularly among the elderly. The choice between cemented and uncemented prostheses remains controversial, especially in populations with varying bone densities and healthcare resources. This study compares functional outcomes, complication rates, and perioperative variables between cemented and uncemented THA in elderly Bangladeshi patients.Methods: This prospective observational study included 60 patients aged 65 years and above undergoing THA due to primary hip OA. Patients were divided into two groups: Group A (cemented, n=30) and Group B (uncemented, n=30). Outcomes were assessed using the Harris Hip Score (HHS), range of motion (ROM), intraoperative blood loss, surgery duration, hospital stay, and postoperative complications. Data were analyzed using SPSS v25.0 with p<0.05 considered statistically significant.Results: At six months, the cemented group demonstrated a significantly higher mean HHS (88.6 ± 6.3) compared to the uncemented group (85.2 ± 7.1, p=0.03). ROM improvement was also greater in the cemented group. Complication rates were higher in the uncemented group (10% vs 6.7%). No statistically significant difference was found in surgery time, blood loss, or hospital stay.Conclusion: Cemented THA yields better functional outcomes in elderly patients with OA in Bangladesh. Given its cost-effectiveness and lower complication profile, cemented prosthesis may be more suitable for this population.
Keywords: Total Hip Arthroplasty, Cemented Prosthesis, Uncemented Prosthesis, Osteoarthritis, Elderly, Bangladesh
References
Abdulkarim, A., Ellanti, P., Motterlini, N., Fahey, T., & O'Byrne, J. M. (2013). Cemented versus uncemented fixation in total hip replacement: A systematic review and meta-analysis of randomized controlled trials. Orthopedic Reviews, 5(1), e8.
Aboushelib, M. N., de Jager, N., Kleverlaan, C. J., Feilzer, A. J., Blatz, M. B., Oppes, S., & Holst, S. (2008). Hip reconstruction. Quintessence International, 39, 23–32.
Brown, T. E., Larson, B., Shen, F., & Moskal, J. T. (2002). Thigh pain after cementless total hip arthroplasty: Evaluation and management. Journal of the American Academy of Orthopaedic Surgeons, 10(6), 385–392.
Carlson, S. W., Goetz, D. D., Liu, S. S., Greiner, J. J., & Callaghan, J. J. (2016). Minimum 10-year follow-up of cementless total hip arthroplasty using a contemporary triple-tapered titanium stem. Journal of Arthroplasty, 31(10), 2231–2236.
Chan, Y. K., Chiu, K. Y., Yip, D. K., Ng, T. P., & Tang, W. M. (2003). Full weight bearing after non-cemented total hip replacement is compatible with satisfactory results. International Orthopaedics, 27, 94–97.
Chen, C., Shi, Y., Wu, Z., Gao, Z., Chen, Y., Guo, C., & Bao, X. (2021). Long-term effects of cemented and cementless fixations of total knee arthroplasty: A meta-analysis and systematic review of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 16, 1–4.
D'Ambrosi, R., Marciandi, L., Frediani, P. V., & Facchini, R. M. (2016). Uncemented total hip arthroplasty in patients younger than 20 years. Journal of Orthopaedic Science, 21(4), 500–506.
Davis, C. M. III, Berry, D. J., & Harmsen, W. S. (2003). Cemented revision of failed uncemented femoral components of total hip arthroplasty. The Journal of Bone and Joint Surgery, 85(7), 1264–1269.
Emara, A. K., Ng, M., Krebs, V. E., Bloomfield, M., Molloy, R. M., & Piuzzi, N. S. (2021). Femoral stem cementation in hip arthroplasty: The know-how of a "lost" art. Current Reviews in Musculoskeletal Medicine, 14(1), 47–59.
Fabi, D. W., & Levine, B. R. (2012). Porous coatings on metallic implant materials. In Materials for Medical Devices (pp. 307–319).
Hailer, N. P., Garellick, G., & Kärrholm, J. (2010). Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register: Evaluation of 170,413 operations. Acta Orthopaedica, 81(1), 34–41.
Herberts, P., & Malchau, H. (2000). Long-term registration has improved the quality of hip replacement: A review of the Swedish THR Register comparing 160,000 cases. Acta Orthopaedica Scandinavica, 71(2), 111–121.
Khanuja, H. S., Vakil, J. J., Goddard, M. S., & Mont, M. A. (2011). Cementless femoral fixation in total hip arthroplasty. Journal of Bone and Joint Surgery—American Volume, 93(5), 500–509.
Kim, Y. H., Park, J. W., Kim, J. S., & Kim, I. W. (2016). Twenty-five-to twenty-seven-year results of a cemented vs a cementless stem in the same patients younger than 50 years of age. The Journal of Arthroplasty, 31(3), 662–667.
Langslet, E., Frihagen, F., Opland, V., Madsen, J. E., Nordsletten, L., & Figved, W. (2014). Cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures: 5-year follow-up of a randomized trial. Clinical Orthopaedics and Related Research, 472, 1291–1299.
Learmonth, I. D., Young, C., & Rorabeck, F. (2007). The debate about cementless fixation in total hip arthroplasty. Journal of Bone and Joint Surgery—British Volume, 89(2), 207–214.
Mäkelä, K. T., Matilainen, M., Pulkkinen, P., Fenstad, A. M., Havelin, L., Engesaeter, L., Furnes, O., Pedersen, A. B., Overgaard, S., Kärrholm, J., & Malchau, H. (2014). Failure rate of cemented and uncemented total hip replacements: Register study of combined Nordic database of four nations. BMJ, 348.
Mencia, M. M., Bidaisee, S., Pong, C. Y., & Hoford, R. (2021). Successful treatment of an osteoporotic posterior fracture-dislocation of the hip in a low-resource setting using the combined hip procedure. Arthroplasty Today, 10, 68–72.
Morshed, S., Bozic, K. J., Ries, M. D., Malchau, H., & Colford, J. M. Jr. (2007). Comparison of cemented and uncemented fixation in total hip replacement: A meta-analysis. Acta Orthopaedica, 78(3), 315–326.
National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. (2022). 19th Annual Report. London: NJR.
Niemeläinen, M. J., Mäkelä, K. T., Robertsson, O., W-Dahl, A., Furnes, O., Fenstad, A. M., Pedersen, A. B., Schrøder, H. M., Reito, A., & Eskelinen, A. (2020). The effect of fixation type on the survivorship of contemporary total knee arthroplasty in patients younger than 65 years of age: A register-based study of 115,177 knees in the Nordic Arthroplasty Register Association (NARA) 2000–2016. Acta Orthopaedica, 91(2), 184–190.
Palan, J., Smith, M. C., Gregg, P., Mellon, S., Kulkarni, A., Tucker, K., Blom, A. W., Murray, D. W., & Pandit, H. (2016). The influence of cemented femoral stem choice on the incidence of revision for periprosthetic fracture after primary total hip arthroplasty: An analysis of national joint registry data. The Bone & Joint Journal, 98(10), 1347–1354.
Synder, M., Drobniewski, M., & Sibinski, M. (2012). Long-term results of cementless hip arthroplasty with ceramic-on-ceramic articulation. International Orthopaedics, 36(11), 2225–2229.
Vijapura, A., Levine, H. B., Donato, M., Hartzband, M. A., Baker, M., & Klein, G. R. (2018). Total hip arthroplasty in patients with avascular necrosis after hematopoietic stem cell transplantation. Orthopedics, 41(2), e257–e261.
Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81(9), 646–656.
Xiang, Z., Chen, Z., Wang, P., Zhang, K., Liu, F., Zhang, C., Wong, T. M., Li, W., & Leung, F. (2021). The effect of early mobilization on functional outcomes after hip surgery in the Chinese population: A multicenter prospective cohort study. Journal of Orthopaedic Surgery, 29(3), 23094990211058902.
You, Q., Lu, M., Min, L., Zhang, Y., Luo, Y., Zhou, Y., & Tu, C. (2022). Hip-preserving reconstruction using a customized cemented femoral endoprosthesis with a curved stem in patients with short proximal femur segments: Mid-term follow-up outcomes. Frontiers in Surgery, 9, 991168.
Zhang, C., Yan, C. H., & Zhang, W. (2017). Cemented or cementless fixation for primary hip arthroplasty—Evidence from the International Joint Replacement Registries. Annals of Joint.
Zhu, Y., Chen, W., Sun, T., Zhang, X., Liu, S., & Zhang, Y. (2015). Risk factors for the periprosthetic fracture after total hip arthroplasty: A systematic review and meta-analysis. Scandinavian Journal of Surgery, 104(3), 139–145.
Zwartelé, R. E., Witjes, S., Doets, H. C., Stijnen, T., & Pöll, R. G. (2012). Cementless total hip arthroplasty in rheumatoid arthritis: A systematic review of the literature. Archives of Orthopaedic and Trauma Surgery, 132, 535–546.
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