Cemented or cementless fixation for primary hip arthroplasty—evidence from The International Joint Replacement Registries

The best fixation method (i.e., cemented or cementless) in primary total hip arthroplasty (THA) remains controversial. We reviewed the most updated annual reports from 5 international joint replacement registries with more than 5-year follow up (Sweden, Norway, England-Wales, Australia and New Zealand). We aimed at discovering the fixation method that leads to better long-term survival and less implant-related complications. In addition, we systemically reviewed several randomized controlled trials (RCTs) that were currently available in literature. We concluded that cemented fixation had better overall long-term survivorship than cementless fixation in primary THA. After age stratification, cemented fixation had better survival in older patients while cementless fixation had better survival in younger patients. Periprosthetic fractures were more common in cementless fixation and thus such risk should be informed to patients before surgery.