title: Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Orthopaedic Surgery, Medisch Spectrum Twente, P.O. Box 50000 , 7500, KA Enschede, The Netherlands. d.pakvis@mst.nl
authors.forename: Dean
authors.initials: D
authors.lastname: Pakvis
authors.forename: Gijs
authors.initials: G
authors.lastname: van Hellemondt
authors.forename: Enrico
authors.initials: E
authors.lastname: de Visser
authors.forename: Wilco
authors.initials: W
authors.lastname: Jacobs
authors.forename: Maarten
authors.initials: M
authors.lastname: Spruit
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements; D002983:Clinical Competence; D016206:Databases, Bibliographic; D005270:Femur Head / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D011475:Prosthesis Failure; D011859:Radiography; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation
chemical_list: D001843:Bone Cements