Is it justified to cement all sockets?

Abstract

Cemented sockets have provided good long-term outcome with lower overall re-operation rates than cementless designs. Results of cementless sockets implanted with polyethylene liners have been disappointing with increased wear rates and a higher incidence of pelvic and femoral osteolysis. Re-operation rates for problems on the socket side have been higher in almost all reports of cementless socket results. There are no long-term results of using highly cross-linked polyethylene liners; likewise, the fate of hard on hard bearings with contemporary socket design is not known. Results using cemented sockets are further improved when contemporary surgical techniques are used, with published evidence of a low risk for revision at more than fifteen years. With cemented sockets, the likelihood of long term success can be estimated on the first postoperative radiograph and there is strong evidence that the longevity of any socket with regard to mechanical loosening is determined by the surgeon and his/her team on the day of surgery. © 2005 Springer Medizin Verlag Heidelberg.