International Orthopaedics

, Volume 37, Issue 1, pp 9–14 | Cite as

Is there evidence for accelerated polyethylene wear in uncemented compared to cemented acetabular components? A systematic review of the literature

  • Hugo C. van der VeenEmail author
  • Hans-Peter W. van Jonbergen
  • Rudolf W. Poolman
  • Sjoerd K. Bulstra
  • Jos J. A. M. van Raay
Review Article


Joint arthroplasty registries show an increased rate of aseptic loosening in uncemented acetabular components as compared to cemented acetabular components. Since loosening is associated with particulate wear debris, we postulated that uncemented acetabular components demonstrate a higher polyethylene wear rate than cemented acetabular components in total hip arthroplasty. We performed a systematic review of the peer-reviewed literature, comparing the wear rate in uncemented and cemented acetabular components in total hip arthroplasty. Studies were identified using MEDLINE (PubMed), EMBASE and the Cochrane Central Register of Controlled Trials. Study quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. The search resulted in 425 papers. After excluding duplicates and selection based on title and abstracts, nine studies were found eligible for further analysis: two randomised controlled trials, and seven observational studies. One randomised controlled trial found a higher polyethylene wear rate in uncemented acetabular components, while the other found no differences. Three out of seven observational studies showed a higher polyethylene wear in uncemented acetabular component fixation; the other four studies did not show any differences in wear rates. The available evidence suggests that a higher annual wear rate may be encountered in uncemented acetabular components as compared to cemented components.


Wear Rate UHMWPE Aseptic Loosening Acetabular Component Polyethylene Wear 
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.



We thank Mr. Wieger de Jong, medical librarian at Martini Ziekenhuis Groningen, for assisting in the literature search

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Hugo C. van der Veen
    • 1
    Email author
  • Hans-Peter W. van Jonbergen
    • 2
  • Rudolf W. Poolman
    • 3
  • Sjoerd K. Bulstra
    • 4
  • Jos J. A. M. van Raay
    • 1
  1. 1.Department of Orthopaedic SurgeryMartini HospitalGroningenThe Netherlands
  2. 2.Department of Orthopaedic SurgeryDeventer HospitalDeventerThe Netherlands
  3. 3.Department of Orthopaedic SurgeryOnze Lieve Vrouwe GasthuisAmsterdamThe Netherlands
  4. 4.Department of Orthopaedic SurgeryUniversity Medical Center GroningenGroningenThe Netherlands

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