Are cementless acetabular components contra-indicated in the elderly?

The long-term success of primary total hip arthroplasty in elderly patients has been well documented. In addition, the use of uncemented acetabular components in younger patients has been well established. However, as yet, there has not been widespread use of uncemented acetabular components in older patients. This study reviews a single surgeon series of 179 consecutive primary total hip replacements using an uncemented acetabular component. Patients were followed up clinically, radiologically and by means of a postal questionnaire. Patients were divided into under-70 years (n = 80) and 70 years and older (n = 99). There were 88 males and 91 females who were followed up to a mean of 24.1 months. There were no significant differences between the groups with respect to the need for additional screw fixation, post-operative complications or implant loosening. Functionally, no differences were recorded in terms of pain, limp, mobility or ability to put on shoes and socks post-operatively. There was no significant difference between the two groups in the levels of satisfaction reported. These results justify the use of uncemented acetabular components in older patients.