Cement versus cementless quote

[John C]

Hi all. It has been quite a while since the cemented versus cementless fixation for femoral components conversation has appeared on this site. I think this is a good sign that both types have been showing good results, and most people are satisfied with whichever option their surgeon recommends.
This morning I ran across some statements on the topic from one of the top knee surgeons in the country, who does a lot of work on the knees of both professional and amateur athletes. The conviction behind the quote made me want to share it here on the forum. I am not really looking to reignite old debates, so much as just offer the opinion of a respected expert in the field, who I choose not to name since it appeared in an email to me, and did not come with approval to be spread with his name attached.
Here is the quote: "No matter how well I cemented in the components of the new knees, I was limited by the survival of the cement. Over time, the cement inevitably breaks down. So the cement-bone interface was the weak link, especially for my patients who wanted to return to a high level of athletic performance."
Certainly the nature of the loading forces, particularly shear forces, are quite different between a hip and a knee, so this surgeons observations with total knee replacements may or may not be relevant to hip resurfacing. However, I thought that this quote from a highly respected source was worth sharing on this great site.

[grants]

Hi John, that is interesting.  I just got a HR cross-poly insert with un-cemented femoral component from Dr. Pritchett at the end of August.  He and Dr. Gross, who i think did yours, seem to be quite innovative and for the systems that are more specialized to them they use an un-cemented femoral component.  So that is interesting.  But as I was choosing between BHR and the cross-poly, I pushed on the cement issue that i read a bit about on the site and there was good comfort cement or no-cement.  So likely it doesn't show a statistical difference over time.  Another interesting thing is the H1 ceramic system being tested is cementless. My personal uneducated non-medical opinion is they both work very well but 10 years from now they just won't use it to just reduce the elements in the process.

Grant

[John C]

Thanks for chipping in grants. I completely agree with everything you said.

[karlos.bell]

Hi Guys
 I did read somewhere cement system over time the body replaces the cement basically with tissue (bone). It however is a long time. I was unable to get cement-less due to the travel home and risk of being so far away around the world from him.
So I got cemented femoral only
More of a debate to keep on a good diet intake as well for calcium absorption.
There is also the biocompatibility of the body with regards to Chromium Cobalt so if your body can except this well it would assume the above can happen well.
I am also unsure of how long they first were cementing the BHR for example things like this would be a great indicator.
John I skied for my first time in 12 years was great to be on the snow.
But hell I need some new carvers and boots the rental stuff was a bit loose.
I was stoked with only 2 can offs and the legs held up well for me.
I completed an off road half marathon a couple of weeks before real slow but did do it and that was massively hard while working, the odd training run. I am no fittness buff.
Quite a life changer for me as my kids have never seen me ski before. I take it easy though and don’t push it.
Great to be back on my legs again. Not even half stiff the next day!
Cheers K

[avilax777]

I have AVN and I think for AVN uncemented seems to do better seems like both Dr Pritchett and Gross agreed when I saw them. 

GANTS I am scheduled for surgery with Dr Prtichett I was wondering if you can private message me and help me with some questions. 

thanks
avi