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Primary Total Hip Arthroplasty With a Noncemented Acetabular Implant
Noncemented acetabular component fixation can be used in all primary and revision total hip arthroplasty (THA) procedures. Diagnoses commonly include primary osteoarthritis, osteoarthritis secondary to acetabular dysplasia or femoroacetabular impingement, posttraumatic arthritis, osteonecrosis, inflammatory arthritis, protrusio acetabuli, and fracture of the femoral neck. The development of implants with highly porous high-friction materials has allowed use of noncemented implants patients with prior pelvic irradiation, which was previously considered a contraindication to the use of noncemented fixation. The stable fixation afforded by contemporary noncemented acetabular implants and the lower wear rates of highly cross-linked polyethylene have allowed the use of larger-diameter femoral heads (32 to 36 mm) and the increased use of THA in younger and active patients. Recently published studies suggest a substantial reduction in the wear of highly cross-linked polyethylene materials even when used in patients younger than 50 years.