International Orthopaedics

, Volume 35, Issue 8, pp 1109–1118 | Cite as

Is there evidence for a superior method of socket fixation in hip arthroplasty? A systematic review

  • Dean PakvisEmail author
  • Gijs van Hellemondt
  • Enrico de Visser
  • Wilco Jacobs
  • Maarten Spruit
Review Article



Total hip arthroplasty has been a very succesful orthopaedic procedure. The optimal fixation method of the acetabular component however, has not yet been defined.


We performed a systematic review using the Medline and Embase databases to find evidence for the superiority of cemented or cementless acetabular components on short- and long-term clinical and radiological parameters. Methodological quality for randomised trials was assessed using the van Tulder checklist, and for the non randomised studies we used the Newcastle-Ottawa quality assessment scale.


Our search strategy revealed 16 randomised controlled trials (RCT) and 19 non RCT studies in which cemented and cementless acetabular components are compared. A best evidence analysis for complications, wear, osteolysis, migration and clinical scores showed no superiority for either cemented or cementless socket in the RCTs. A best evidence analysis for non RCT studies revealed better osteolysis, migration properties and aseptic loosening survival for cementless sockets; however, wear and overall survival favoured the cemented sockets.


We recommend that an orthopaedic surgeon should choose an established cemented or cementless socket for hip replacement based on patient characteristics, knowledge, experience and preference.


Aseptic Loosening Acetabular Component Randomise Control Trial Study Cementless Fixation Cementless Acetabular Component 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest statement

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Dean Pakvis
    • 1
    Email author
  • Gijs van Hellemondt
    • 2
  • Enrico de Visser
    • 3
  • Wilco Jacobs
    • 4
  • Maarten Spruit
    • 2
  1. 1.Department of Orthopaedic SurgeryMedisch Spectrum TwenteKA EnschedeThe Netherlands
  2. 2.Department of Orthopaedic SurgeryNijmegenThe Netherlands
  3. 3.Department of Orthopaedic SurgeryAlysis ZorggroepArnhemThe Netherlands
  4. 4.OrthoResearch UnitSt. Maartens Kliniek Research, Development and EducationNijmegenThe Netherlands

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