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Clinical Orthopaedics and Related Research®

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01-01-2011 | Clinical Research

What Works Best, a Cemented or Cementless Primary Total Hip Arthroplasty?: Minimum 17-year Followup of a Randomized Controlled Trial

Authors: Kristoff Corten, MD, Robert B. Bourne, MD, FRCS(C), Kory D. Charron, Dipl.MET, Keegan Au, MD, FRCS(C), Cecil H. Rorabeck, MD, FRCS(C)

Published in: Clinical Orthopaedics and Related Research® | Issue 1/2011

Abstract

Background

Total hip arthroplasty (THA) has been associated with high survival rates, but debate remains concerning the best fixation mode of THA.

Questions/purposes

We conducted a randomized controlled trial (RCT) with 250 patients with a mean age of 64 years between October 1987 and January 1992 to compare the results of cementless and cemented fixation.

Patients and Methods

Patients were evaluated for revision of either of the components. One hundred twenty-seven patients had died (51%) and 12 (4.8%) were lost to followup. The minimum 17-year followup data (mean, 20 years; range, 17–21 years) for 52 patients of the cementless group and 41 patients of the cemented group were available for evaluation.

Results

Kaplan-Meier survivorship analysis at 20 years revealed lower survival rates of cemented compared with cementless THA. The cementless tapered stem was associated with a survivorship of 99%. Age younger than 65 years and male gender were predictors of revision surgery.

Conclusions

The efficacy of future RCTs can be enhanced by randomizing patients in specific patient cohorts stratified to age and gender in multicenter RCTs. Including only younger patients might improve the efficacy of a future RCT with smaller sample sizes being required. A minimum 10-year followup should be anticipated, but this can be expected to be longer if the difference in level of quality between the compared implants is smaller.

Level of Evidence

Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Available only for authorised users

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Title: What Works Best, a Cemented or Cementless Primary Total Hip Arthroplasty?: Minimum 17-year Followup of a Randomized Controlled Trial
Authors: Kristoff Corten, MD
Robert B. Bourne, MD, FRCS(C)
Kory D. Charron, Dipl.MET
Keegan Au, MD, FRCS(C)
Cecil H. Rorabeck, MD, FRCS(C)
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 1/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1459-5

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What Works Best, a Cemented or Cementless Primary Total Hip Arthroplasty?: Minimum 17-year Followup of a Randomized Controlled Trial

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

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