Prediction of the Long-term Durability of All-polyethylene Cemented Sockets

A retrospective study was done to determine the correlation between the rate of aseptic loosening and the early radiographic appearance of the bone-cement interface of the acetabulum of primary cemented total hip prostheses. Two hundred thirty-six hips implanted with modern cement technique were studied during an average clinical and radiographic followup of 9 years. Early radiographs and the last available radiographs were studied by 3 independent observers, and the quality of the bone-cement interface was evaluated with a standardized scoring system. On the acetabular side, the authors noted 0.8% clinical failure, a 3% rate of radiographic migration, and a 3.4% rate of progressive global radiolucency. Only 2.2% of hips considered well fixed on the postoperative film were loose. Of the hips considered not well fixed, the rate of aseptic loosening was 14.4%. The authors conclude that (1) the state of the bone-cement interface as seen on the early postoperative radiograph can predict the longevity of a cemented socket with a high degree of probability, and that (2) cementation of an all-polyethylene socket using modern cement technique is an excellent method of fixation for patients 60 years of age and older with degenerative joint disease.