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JRPMS Vol 7, No 3, September 2023, p.89-95

doi: 10.22540/JRPMS-07-089


Review Article

Cemented and cementless total hip arthroplasty in patients with osteoporosis: an overview

Ilias P. Mystidis1, Dimitrios Chytas2, Maria Kyriaki Kaseta1, Dimitrios V. Papadopoulos1, Elisavet Mantzila1, Vasiliki Kakogeorgou1, Efstathios Chronopoulos3

  1. 2nd Orthopedic Department of National and Kapodistrian University of Athens, Konstantopoulio-Patission General Hospital, Nea Ionia, Greece
  2. Basic Sciences Laboratory, Department of Physiotherapy, University of Peloponnese, Sparta, Greece
  3. KAT Hospital, Research Department of Musculoskeletal diseases, Kifisia , Greece

Keywords: Cemented total hip arthroplasty, Cementless total hip arthroplasty, Osteoporosis


The purpose of the current review article was to explore to what extent the literature supports cemented or cementless total hip arthroplasty (THA) in osteoporotic patients., in terms of Harris Hip Score, periprosthetic bone loss, periprosthetic fractures, prosthesis subsidence and revision rate. A literature search was performed in PubMed and Cochrane databases to identify articles with purpose to investigate the aforementioned parameters after the use of cemented or cementless THA in patients with osteoporosis or Dorr type C bone, which is typically seen in those patients. Twenty studies were included in the review. Among them, there were two studies which compared cemented with cementless THA in osteoporotic patients and found better outcomes after cemented fixation. The remaining studies investigated only the outcomes of cementless THA in patients with osteoporosis or Dorr type C bone. Most of those studies showed satisfactory outcomes and suggested that cementless THA may not be contraindicated for those patients. The major issue concerning cementless THA was the relatively high rate of periprosthetic fractures. Three studies investigated the use of anti-osteoporotic medication in osteoporotic patients who underwent cementless THA and found positive outcomes. In conclusion, the role of cemented and cementless THA in the case of osteoporosis or Dorr type C bone needs to be further clarified with more comparative studies.