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Orthopedic Surgeons Ponder: How Best to Secure Artificial Hip Prostheses?

Timothy F. Kirn
JAMA. 1987;258(2):173. doi:10.1001/jama.1987.03400020015005.
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MORE THAN 126 000 hip replacement procedures are performed annually in this country and, because of the "graying of America," that number is likely to increase. But orthopedic surgeons are concerned by reports that too many—the number varies with the surgical series being reported—artificial hips become loose and need to be surgically revised.

This raises the question: what is the best way to secure an artificial hip prosthesis in place? There are two competing technologies, one that uses a polymethyl methacrylate cement to anchor the device to the bone and one that uses bone growth into a porous surface to hold it secure.

A definitive answer about which technology is the better and "more permanent" prosthesis may be some time in coming. Until then, orthopedists will continue to debate the relative merits of each, and remain torn between what they can accomplish and the results they would like to achieve.


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