Superior outcomes of cementless total hip arthroplasty in elderly osteoarthritis patients: Findings from a 5-year retrospective cohort study

Total hip arthroplasty (THA) is a common and effective procedure for treating hip osteoarthritis in elderly patients. However, debate persists regarding the optimal fixation method - cemented or cementless. This study aimed to compare outcomes between cemented and cementless THA in elderly patients over a 5-year period. This retrospective cohort study analyzed 121 THAs (93 cemented and 28 uncemented) performed on elderly patients (≥50 years) with advanced hip osteoarthritis from April 2018 to October 2023. Outcomes assessed included pain (Visual Analog Scale), functional mobility (WOMAC), postoperative complications, and quality of life (EQ-5D-5L). Statistical analysis included t-tests and chi-square tests to compare outcomes between groups. Cementless THA demonstrated significantly better outcomes across all measures at an average follow-up of 36 months. Patients in the cementless group reported lower postoperative pain levels (p < 0.001), improved functional mobility (p < 0.001), fewer complications (p < 0.001), and higher quality of life scores (p < 0.001) compared to the cemented group. This study provides strong evidence supporting the superiority of cementless THAover cemented THA in elderly patients with hip osteoarthritis. Cementless fixation resulted in better pain relief, functional outcomes, safety profile, and overall quality of life. These findings suggest that cementless THA should be considered the preferred option for suitable elderly patients undergoing hip replacement surgery.