What is the difference between cemented and uncemented hip replacement surgery?

Hip replacement surgery is a surgical procedure that removes parts, or all, of the hip joint (that is, the junction between the pelvis and the femur) and replaces it with an artificial implant. After this, a surgeon may choose between a cemented or an uncemented hip replacement to fix the implant to the bone.

Here, Mr Nezar Tumia, renowned orthopaedic consultant surgeon, provides an expert insight into cemented and uncemented hip replacement surgery.

How do cemented and uncemented hip replacement surgeries differ?

There are three types of hip replacement surgery:

1. Cemented total hip replacement
2. Uncemented total hip replacement
3. Hybrid total hip replacement

All three types are good options to treat different types of hip diseases and allow the patient to return to normal activities.

As well as these, there are also different types of articulating surfaces, such as metal-on-polyethylene, ceramic-on-polyethylene, and ceramic-on-ceramic surface.

How is the most suitable procedure, either cemented or uncemented, chosen for the patient?

There are different factors that need to be considered when choosing which type of hip replacement and which type of articulating surface to use for different patients. These factors include age, bone quality, type of hip disease, leg length discrepancy, and the patient’s level of activity.

In general, uncemented total hip replacement is performed in a younger age group with good bone density.

Normally, a ceramic hip will be used with an uncemented type of hip replacement. The ceramic surface is very smooth and wears away less than a metal surface. It is scratch-resistant material. For this reason, it can increase the longevity of a total hip replacement in a younger age group who have a higher physical demand than an older age group.

On the other hand, cemented hip replacement is usually performed in an older age group with a lower demand and less physical activity.

Are the risks of a cemented hip replacement higher?

Both cemented and uncemented total hip replacement surgery are safe operations to perform as long as they are performed correctly with all the precautions in place.

Is there a difference in recovery time for a cemented or uncemented hip replacement surgery?

The recovery for both types of hip replacement surgery is the same. Patients start mobilising on the same day of their operation with the use of walking aids, and can go home either on the same day of surgery or on the following day.

The walking aids can be used between two to four weeks.

Is an uncemented hip replacement more likely to need redo surgery in the future? Why?

Both cemented and uncemented total hip replacement surgery can last for a very long time. At least 90 per cent of patients will have their hip replacement for more than 20 years.

According to the National Joint Registry, uncemented cups tend to last longer than their cemented equivalent. Hence, there is a tendency to use uncemented hips in a younger age group.

What precautions are associated with cemented hip replacement surgery? And uncemented?

Patients, following cemented or uncemented total hip replacement surgery, can return to a normal level of activity and exercise.

However, it is recommended to avoid high-impact types of exercises to increase the longevity of the joint replacement. Patients can return to and enjoy playing different types of sports, such as cycling, skiing, swimming and hiking.

Mr Nezar Tumia is an esteemed orthopaedic consultant surgeon with over 25 years’ experience.

If you require cemented, uncemented or hybrid hip replacement surgery and would like to discuss your options with an expert, do not hesitate to book an appointment with Mr Tumia via his Top Doctors profile today.