title: Twenty-Five- to Twenty-Seven-Year Results of a Cemented vs a Cementless Stem in the Same Patients Younger Than 50 Years of Age.
abstract: BACKGROUND
  No study to our knowledge evaluated the long-term survivorship of the contemporary cemented vs cementless stems more than 25 years of follow-up in the same patients younger than 50 years of age.
  
  
  OBJECTIVE
  The purpose of the study is to determine (1) validated outcome scores, (2) prevalence of polyethylene wear and osteolysis, and (3) survivorship of the cemented vs cementless femoral components in the same young patients at minimum follow-up of 25 years.
  
  
  METHODS
  We report 171 patients (mean age, 47.7 years) at the time of the surgery who received simultaneous bilateral total hip arthroplasty with a cemented stem in one hip and a cementless stem in the other (26.1-year follow-up). A cementless acetabular component was used in all hips. There were 125 men and 46 women. The mean age at the time of the arthroplasty was 47.7 ± 10.7 years (range, 21-50 years).
  
  
  RESULTS
  The average Harris hip scores were similar between the groups of cemented stem (mean, 91 points) and cementless stem (93 points). Survival rate of the acetabular component (79% vs 78%) and that of the femoral component (96% vs 95%) at 26.1 years were similar between the 2 groups.
  
  
  CONCLUSIONS
  The long-term fixation of the acetabular metallic shell and cemented or cementless femoral stem was outstanding. Polyethylene wear and periacetabular osteolysis were contributing factors to reduce the long-term survival of the contemporary total hip arthroplasties with or without cement in young patients. New bearing surfaces such as ceramic on ceramic or ceramic on highly cross-linked polyethylene would improve wear of the bearing surfaces.
authors.affiliation: The Joint Replacement Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Young-Hoo
authors.initials: YH
authors.lastname: Kim
authors.affiliation: The Joint Replacement Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jang-Won
authors.initials: JW
authors.lastname: Park
authors.affiliation: The Joint Replacement Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jun-Shik
authors.initials: JS
authors.lastname: Kim
authors.affiliation: The Joint Replacement Center, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: In-Woo
authors.initials: IW
authors.lastname: Kim
mesh_terms: D000077:Acetabulum / Q000601:surgery; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001672:Biocompatible Materials; D001843:Bone Cements; D002484:Cementation; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D020959:Polyethylene; D015995:Prevalence; D011475:Prosthesis Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D001843:Bone Cements; D020959:Polyethylene
keywords: cemented; cementless; femoral stem; long-term results; young patients