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Fixation Techniques in THR

Cement vs biological interdigitation of bone / prosthetic interface. Remains controversial. National Inst. Of Health (USA) recommends cemented stem, uncemented cup based on their understanding of the results.

Trend to uncemented is being reasoned by incr loosening rates of cemented prosthesis in young active patients.

Cement Fixation:

Mechanical interlock between PMMA and bone – static interlock. If microfractures occur with cyclical loading then remodelling of cement cannot happen and will get loosening. With biological fix – it is dynamic and so potential for remodelling. Also if no cement then one less interface that can potentially fail. (Further Cement info. later)

Biological Fixation:

Porous coat – allows for bone INGROWTH



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