Bone cement is rarely used today for fixation of hip components. My preferred method is to use “uncemented” stems and cups for replacing joints. I use cement only if the structure of the bone does not allow placement of an uncemented prosthesis in an acceptable manner.
Additional circumstances where I may consider the use of cement is for pathological fractures of the hip that are seeded with metastasis from a primary source elsewhere in the body. For pathological fractures with metastasis, I use zoledronic acid with bone cement. This technique of mixing a drug with bone cement has provided excellent pain relief after pathological hip fractures that are treated with hip replacement surgery.
The reason for using uncemented prosthesis are numerous. The long terms result of uncemented hip prosthesis are excellent. Uncemented prosthesis are little more forgiving for “varus placement” in the hip joint which means that the prosthesis is more tilted when placed into the hip joint. Additionally cement has been associated with embolism, which means that the cement when pressurized into the bone can leak into the blood vessels and can go into the cardiovascular system causing issues.