title: Total hip replacement: the case for noncemented femoral fixation because of age.
abstract: Both noncemented fixation and improved cemented fixation of total hip replacements emerged to counteract the clinical and radiographic failures of early cemented procedures. A randomized clinical trial comparing a second-generation cemented with a second-generation noncemented total hip replacement demonstrated that in the medium term both implants allow excellent, disease-specific, global and functional capacity outcome measures. No significant differences existed between the cemented and noncemented implants in terms of these parameters or revision rate. Cost-to-utility analyses of both types of replacements revealed that total hip replacement is one of the most cost-effective medical interventions. Noncemented total hip replacements seem as efficacious as cemented devices in patients younger than 70 years.
authors.affiliation: Department of Surgery, University Hospital, University of Western Ontario, London.
authors.forename: R B
authors.initials: RB
authors.lastname: Bourne
authors.forename: C H
authors.initials: CH
authors.lastname: Rorabeck
authors.forename: A
authors.initials: A
authors.lastname: Laupacis
authors.forename: D
authors.initials: D
authors.lastname: Feeny
authors.forename: P S
authors.initials: PS
authors.lastname: Tugwell
authors.forename: C
authors.initials: C
authors.lastname: Wong
authors.forename: R
authors.initials: R
authors.lastname: Bullas
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001843:Bone Cements; D003362:Cost-Benefit Analysis; D006305:Health Status Indicators; D006622:Hip Prosthesis / Q000191:economics / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D011788:Quality of Life
chemical_list: D001843:Bone Cements