We reviewed the radiographs of 137 patients (137 hips) who had been
managed with a total hip arthroplasty, with insertion of an extensively
porous-coated femoral component without cement, because of osteoarthrosis
or avascular necrosis. A porous-coated acetabular component had been
inserted with cement in sixty-three of these patients (Group A) and without
cement in seventy-four patients (Group B). The radiographs were examined
for osteolysis, either directly adjacent to the joint or at locations
remote from the joint. The mean duration of follow-up was 105 months
(range, fifty-four to 142 months). The rate of osteolysis of the acetabulum
in the unrevised hips in which the acetabular component had been inserted
with cement was 37 per cent (nineteen of fifty-one). The osteolysis was
most frequently of the linear type, a pattern that was associated with a
high prevalence of loosening in the hips that had a cemented cup (30 per
cent [nineteen of sixty-three]). The rate of acetabular osteolysis (18 per
cent [thirteen of seventy-one]) in the patients who had a cup that had not
been inserted with cement and that had not been revised was not as high as
that associated with the surviving cups that had been inserted with cement
(p < 0.05). The osteolysis associated with the cups that had not been
inserted with cement was localized and expansile, and it was not associated
with loosening of the component. However, it produced more loss of bone
than did the linear pattern of osteolysis around the cemented
cups.(ABSTRACT TRUNCATED AT 250 WORDS)