During cemented total hip replacement, the Charnley design uses a stainless-steel femoral head with a high-density polyethylene acetabular cup. The main advantage of cementless (press-fit) over cemented fixation in a 65-year-old active patient is:

• A Better initial fixation strength in the first 24 hours
• B Avoidance of cement-related cardiovascular complications during implantation
• C Superior long-term bone ingrowth without cement mantle fatigue ✓
• D Lower cost and easier surgical technique

Explanation

Cementless (press-fit, ingrowth) fixation relies on primary mechanical stability followed by osseointegration into porous titanium or hydroxyapatite-coated surfaces, eliminating cement mantle fatigue fracture — a cause of late aseptic loosening in cemented implants. In active younger-elderly patients, long-term biological fixation is more durable and revision is easier without cement removal. Cemented THR has BETTER initial fixation (immediate stability) but risks cement cardiovascular events (bone cement implantation syndrome — fat/marrow embolism). Cementless surgery is technically more demanding and more expensive.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.