Initial fixation of the femoral component in hip resurfacing is key to the enduring survival of the prosthesis. Cementing
the metaphyseal stem increases the interface area between bone and cement. We compared the clinical and survivorship results
of two groups in a cohort of 1000 hips (838 patients) implanted with Conserve
® Plus hip resurfacing; one group was resurfaced with a cemented metaphyseal stem (400 hips; Group 1) and the other with a
press-fit stem (600 hips; Group 2). We carried out a time-dependent analysis to determine the indications for cementing the
stem. The 5-year Kaplan-Meier survival estimate was 98.2% for Group 1 and 94.4% for Group 2, using any revision as an endpoint.
Femoral aseptic failure was reduced in Group 1 compared to Group 2. Cementing the metaphyseal stem is particularly effective
for hips with a small femoral component size (< 48 mm) and hips with large femoral defects (> 1 cm). There was no difference
between groups in incidence of femoral neck narrowing or femoral neck fractures. Longer followup is needed to determine if
cementing the stem can be detrimental to the long-term durability of the femoral implant.
Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
One or more of the authors (HCA - MLD) have received funding from St Vincent Medical Center, Los Angeles, CA, and Wright Medical
Technologies, Inc, Arlington, TN. Each author certifies that he has or may receive payments or benefits from a commercial
entity related to this work.
Each author certifies that his or her institution has approved the reporting of this case report, that all investigations
were conducted in conformity with ethical principles of research.