Comparative Study of Functional Outcomes Between Cemented and Uncemented Total Hip Replacement at a Tertiary Care Hospital in Odisha, India

TL;DR

The study compares cemented and uncemented total hip replacements in Odisha, India, finding cemented implants offer better short-term outcomes and early mobility.

Contribution

The study provides a comparative analysis of cemented and uncemented THR outcomes in a specific Indian population, highlighting cost-effectiveness and functional benefits.

Findings

Cemented THR showed significantly lower pain scores at three and six months compared to uncemented THR.

Functional outcomes measured by HHS and WOMAC favored cemented implants at three months, six months, and one year.

Cemented implants allow early weight-bearing and mobilization, while uncemented implants offer better durability and biological integration.

Abstract

Background

This study aims to assess the clinical and functional outcomes of cemented and uncemented total hip replacement (THR) by comparing the two surgical techniques in Odisha. Also, it aims to assess complications of THR/total hip arthroplasty (THA) by comparing two surgical techniques as well.

Materials and methods

This prospective observational study was conducted in the Department of Orthopedics and Trauma, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, from March 2022 to September 2023. A total of 60 patients undergoing primary THR were enrolled and categorized into cemented and uncemented groups. Clinical evaluations were conducted using the Visual Analogue Scale (VAS), Harris Hip Score (HHS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at six weeks, three months, six months, and 12 months.

Results

The mean age of patients in the cemented THR group was 55.53 years, while the uncemented group had a mean age of 52.60 years. Pain levels, assessed using the VAS, were similar between groups at the six-week follow-up. However, at three months (p ≤ 0.0001) and six months (p = 0.0001), the cemented group reported significantly lower VAS scores, indicating more effective early pain control and likely improved initial osseointegration. Functional outcomes, measured by the HHS and the WOMAC, also favored the cemented group. Statistically significant differences were observed at three months (p = 0.001), six months (p ≤ 0.05), and at the one-year follow-up (p ≤ 0.05). There was one case of excessive blood loss during surgery in the uncemented group and one case of foot drop in the cemented group. Sixty-six patients were included, but six left the study - four did not meet the inclusion criteria, and two declined to provide consent.

Conclusion

Cemented implants are a more cost-effective option, offering improved short-term outcomes, and also allow for full weight-bearing activities with minimal discomfort. Early movement and mobilization are seen in cemented implants, while uncemented implants offer better durability and avoid cement-related complications, with stronger biological integration. Although the decision between cemented and uncemented THR depends on various patient-specific factors, including age, activity level, bone quality, and overall health, each method has its own risks and benefits that should be considered after detailed deliberation.

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