Cemented Versus Uncemented Total Hip Arthroplasty in Elderly Patients: A Comparative Outcome Study

Open Access

Abstract

Introduction: Total hip arthroplasty (THA) is a widely performed procedure for managing advanced hip pathology in elderly patients, including osteoarthritis, femoral neck fractures, and avascular necrosis. With increasing life expectancy, the choice between cemented and uncemented fixation has become crucial, as bone quality and comorbidities can influence outcomes. This study aimed to compare clinical, functional, and early postoperative outcomes of cemented versus uncemented THA in elderly patients. Methods & Materials: This prospective comparative study was conducted from January 2025 to December 2025 in the Department of Orthopedics, National Institute of Traumatology & Orthopaedic Rehabilitation. A total of 60 patients aged ≥65 years requiring primary THA were enrolled and equally divided into cemented (n = 30) and uncemented (n = 30) groups. Data were analysed using SPSS version 25.0. Result: Primary osteoarthritis was the most common indication. Cemented THA had longer operative time and greater blood loss but no intraoperative fractures, whereas uncemented THA had 10% intraoperative femoral fractures. Postoperative complications were higher in the uncemented group (26.7% vs 13.3%), with periprosthetic fractures occurring only in uncemented THA. At 6 months, cemented THA showed superior functional outcomes (Harris Hip Score 88.6 ± 6.4 vs 84.2 ± 7.1) and a shorter hospital stay (6.8 vs 7.9 days) with fewer early revisions (3.3% vs 13.3%). Conclusion: This study shows that in elderly patients, cemented total hip arthroplasty provides superior early functional outcomes, fewer postoperative complications, shorter hospital stays, and lower rates of early revision compared with uncemented procedures.