RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade
BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty .
Comparison of total hip replacement with and without cement in patients younger than 50 years of age: the results at 18 years.
There have been comparatively few studies of the incidence of osteolysis and the survival of hybrid and cementless total hip replacements ( THRs ) in patients younger than 50 years of age . We prospect ively review ed 78 patients ( 109 hips ) with a hybrid THR having a mean age of 43.4 years ( 21 to 50 ) and 79 patients ( 110 hips ) with a cementless THR with a mean age of 46.8 years ( 21 to 49 ) . The patients were evaluated clinical ly using the Harris hip score , the Western Ontario and McMaster Universities ( WOMAC ) osteoarthritis score and the University of California , Los Angeles ( UCLA ) activity score .  Radiographs and CT scans were assessed for loosening and osteolysis . The mean follow-up was for 18.4 years ( 16 to 19 ) in both groups . The mean post-operative Harris hip scores ( 91 points versus 90 points ) , the mean WOMAC scores ( 11 points versus 13 points ) and UCLA activity scores ( 6.9 points versus 7.1 points ) were similar in both groups . The revision rates of the acetabular component ( 13 % versus 16 % ) and the femoral component ( 3 % versus 4 % ) , and the survival of the acetabular component ( 87 % versus 84 % ) and the femoral component ( 97 % versus 96 % ) were similar in both groups . Although the long-term fixation of the acetabular metallic shell and the cemented and cementless femoral components was outst and ing , wear and peri-acetabular osteolysis constitute the major challenges of THR in young patients
RESULTS The meta- analysis did not reveal any effect of the type of acetabular component fixation on either survivorship or revision rate .
The preference for cementless acetabular components on the basis of improved survivorship is not supported by the published evidence .
Although concerns regarding aseptic loosening of cemented acetabular components may have led North American surgeons toward the nearly exclusive use of cementless acetabular components , the available literature suggests that the fixation of cemented acetabular components is more reliable than that of cementless components beyond the first postoperative decade
BACKGROUND The use of cementless acetabular components in total hip arthroplasty has gained popularity over the past decade .
Most total hip arthroplasties being performed in North America currently use cementless acetabular components .
The objective of this systematic review and meta- analysis was to compare the survivorship and revision rate of cemented and cementless acetabular components utilized in total hip arthroplasty .