Midterm Comparative Analysis of Functional Outcome of Uncemented versus Cemented Total Hip Arthroplasty: A Retrospective Cohort Study

Abstract

Introduction: The key objective of Total Hip Replacement (THR) is to deliver a hip joint that is pain-free, mobile, and stable. For this procedure, both cemented and uncemented methods are offered. Aim: To compare the mid-term functional outcomes of uncemented Total Hip Arthroplasty (THA) versus cemented THA. Materials and Methods: A hospital-based retrospective cohort study was conducted on 60 cases of THA (both cemented and uncemented) operated at a tertiary-level medical institute in north India between January 2012 to December 2018. In this retrospective cohort study, sixty (60) hip replacements (both cemented and uncemented) were performed on patients between the ages of 25 to 70 at a tertiary care institute in rural north India between 2012 and 2018. Patients over the age of 25 who were diagnosed with pure hip arthritis due to conditions such as avascular necrosis, osteoarthritis, or hip developmental dysplasia and who were eligible for either an uncemented or a cemented THA were taken into consideration for inclusion. Retrospective patient monitoring was done based on Harris Hip Score (HHS) from January 2019 to August 2020. Results: In the cemented group, the mean age of the patients was 58.90±8.97, whereas in the uncemented group, it was 52.47±10.29. Out of 30 participants, 17 were male and 13 were female in the cemented group, and 19 male and 11 female participants were included in the study in the uncemented group. The difference between the cemented and uncemented groups’ HHS was significant during the immediate postoperative period (p=0.01). Nevertheless, there was no discernible difference at the long-term follow-up at one year (p=0.76), two years (p=0.20), three years (p=0.29), four years (p=0.86), and five years (p=0.47). Three years following surgery, radiographic evidence of osteolysis and loosening was observed in two instances (6.6%) in the uncemented group and two case (6.6%) in the cemented group. Conclusion: While cemented fixation offers better immediate functional results than uncemented fixation- such as less pain and faster pain-free full weight-bearing. Both have proven to be equally successful in the long run, with statistically insignificant differences.

Keywords

• biological fixation
• cemented fixation
• harris hip score
• total hip replacement