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 .
Inferior Survival of Hydroxyapatite versus Titanium-coated Cups at 15 Years
Hydroxyapatite ( HA ) particles have long been suspected to disintegrate from implant surfaces , become entrapped in joint spaces of orthopaedic bearing couples , and start a cascade leading to progressive polyethylene ( PE ) wear , increased osteolysis , and aseptic loosening . We compared cup revision at 15 years ’ followup in a r and omized group of patients with 26 cementless THA components with titanium ( Ti ) versus first-generation HA coating .  We also assessed radiographic PE wear and osteolysis to the 12-year followup or end point revision at a minimum of 5 years ( mean , 10.9 years ; range , 5–12.6 years ) . Two Ti-coated cups ( 17 % ) and eight HA-coated cups ( 57 % ) were revised at 15 years ’ followup . Femoral head penetration rate was 0.46 mm/year ( st and ard deviation , 0.26 ) with the HA-coated cups ( n = 12 ) and 0.38 mm/year ( st and ard deviation , 0.14 ) with the Ti-coated cups ( n = 10 ) ; we observed a wide variance of linear wear with the HA-coated cups . We also observed a positive association between high wear rate and revision , and between a high volume of osteolysis and revision . Our findings suggest inferior survival of medium-thickness spray-dried HA-coated cups with individual cases of excessive PE wear and premature cup failure . These findings apply to first-generation modular cups and may not apply to other cup design s and new HA-coating technologies . Level of Evidence : Level III , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence
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 .