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Comparative Study
. 2011 Aug;35(8):1109-18.
doi: 10.1007/s00264-011-1234-6. Epub 2011 Mar 15.

Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

Dean Pakvis  1 , Gijs van Hellemondt, Enrico de Visser, Wilco Jacobs, Maarten Spruit
Affiliations
Comparative Study

Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

Dean Pakvis et al. Int Orthop. 2011 Aug.

Abstract

Purpose: Total hip arthroplasty has been a very succesful orthopaedic procedure. The optimal fixation method of the acetabular component however, has not yet been defined.

Methods: We performed a systematic review using the Medline and Embase databases to find evidence for the superiority of cemented or cementless acetabular components on short- and long-term clinical and radiological parameters. Methodological quality for randomised trials was assessed using the van Tulder checklist, and for the non randomised studies we used the Newcastle-Ottawa quality assessment scale.

Results: Our search strategy revealed 16 randomised controlled trials (RCT) and 19 non RCT studies in which cemented and cementless acetabular components are compared. A best evidence analysis for complications, wear, osteolysis, migration and clinical scores showed no superiority for either cemented or cementless socket in the RCTs. A best evidence analysis for non RCT studies revealed better osteolysis, migration properties and aseptic loosening survival for cementless sockets; however, wear and overall survival favoured the cemented sockets.

Conclusions: We recommend that an orthopaedic surgeon should choose an established cemented or cementless socket for hip replacement based on patient characteristics, knowledge, experience and preference.

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Figures

Fig. 1
Fig. 1
Medline and Embase database, the QUOROM statement flow diagram
See this image and copyright information in PMC

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