Hip joint replacement revision with gears and cogs symbolizing surgical process.

Joint Replacement Revision: Cemented vs. Cementless - Which is Right for You?

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"A comprehensive look at cemented and cementless components in joint replacement revision surgeries, offering insights into infection treatment and implant success."

Joint replacement revision surgeries are becoming increasingly common, with a growing need to address issues like infection, loosening, and wear of the original implants. A critical decision in these revisions is whether to use cemented or cementless components. Each approach has distinct advantages and considerations, impacting the overall success of the procedure and the patient’s long-term outcome.

This article delves into the factors influencing the choice between cemented and cementless components during joint replacement revision, particularly focusing on hip and knee arthroplasties. We'll explore the impact of implant fixation methods on infection treatment, implant survivorship, and biomechanics. By examining the latest research and expert opinions, we aim to provide a clear understanding of the optimal strategies for successful joint replacement revision.

Whether you're a patient considering revision surgery or a healthcare professional seeking the best practices, this guide offers valuable insights into making informed decisions about cemented and cementless components. Understanding these nuances can lead to better outcomes, reduced complications, and improved quality of life.

Cemented vs. Cementless: Does it Impact Infection Treatment Success?

Hip joint replacement revision with gears and cogs symbolizing surgical process.

One of the primary questions in joint replacement revision is whether the choice between cemented and cementless components affects the success of treating chronic periprosthetic joint infections (PJIs). According to a consensus from experts in orthopedic infections, there's no direct evidence to suggest that either method inherently leads to a higher success rate in infection treatment.

However, the mode of fixation—how the implant is secured—can influence implant survivorship. The selection of implant and fixation method should be based on the patient's bone mass and quality. If cemented prostheses are used, it's advisable to add antibiotics targeted at the specific infective organisms at the time of reimplantation.

Cemented Fixation: Offers immediate stability, regardless of bone quality. It allows for the integration of antibiotics/antifungals, and securing impaction grafts or large allografts.
Cementless Fixation: Provides long-term biologic fixation. It eases removal in case of acute reinfection and offers modularity to address implant fixation and biomechanics separately.

Historically, cementless fixation has been favored for overall implant survivorship in both aseptic and septic revision surgeries. However, current literature doesn't definitively support one method over the other regarding infection cure rates. Factors such as bone quality, patient health, and surgical technique play significant roles in the overall outcome.

Making the Right Choice for Joint Replacement Revision

Choosing between cemented and cementless components in joint replacement revision requires a comprehensive evaluation of various factors. While there is no definitive evidence that one method is superior for infection treatment, the mode of fixation and patient-specific considerations play crucial roles in implant survivorship and overall success. Consulting with an experienced orthopedic surgeon and considering the latest research will help ensure the best possible outcome for each patient.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.arth.2018.09.030, Alternate LINK

Title: Hip And Knee Section, Treatment, Prosthesis Factors: Proceedings Of International Consensus On Orthopedic Infections

Subject: Orthopedics and Sports Medicine

Journal: The Journal of Arthroplasty

Publisher: Elsevier BV

Authors: Guillem Bori, Michael Kelly, Daniel Kendoff, Mitchell R. Klement, Rafael Llopis, Laurens Manning, Javad Parvizi, Michael J. Petrie, Nemandra A. Sandiford, Ian Stockley

Published: 2019-02-01

Everything You Need To Know

What are the main differences between "cemented" and "cementless" components?

In joint replacement revision surgeries, deciding between "cemented" and "cementless" components is critical. "Cemented" components use a special bone cement to secure the implant, offering immediate stability. "Cementless" components rely on bone growth into the implant surface for long-term stability. The choice significantly affects how the implant is fixed and, consequently, impacts the success of the surgery and the patient's overall outcome.

How does the choice between "cemented" and "cementless" components affect infection treatment in revision surgery?

The distinction between "cemented" and "cementless" components is crucial for managing infections in joint replacement revision. While no direct evidence indicates either method inherently leads to a higher infection treatment success rate, the method of fixation influences implant survivorship. "Cemented" components allow for the addition of antibiotics or antifungals during reimplantation, which can help fight infections. "Cementless" components may ease removal in case of acute reinfection. The selection depends on patient bone quality and specific infection characteristics.

What factors influence the success of joint replacement revision surgery?

Factors like bone quality, patient health, and surgical technique influence the success of joint replacement revision. Patient bone mass and bone quality are critical. "Cemented" components can be used regardless of bone quality, offering immediate stability. "Cementless" components, however, require good bone quality for the bone to grow into the implant, providing long-term stability. The surgeon’s technique ensures proper implant placement and fixation, influencing both short-term and long-term outcomes.

What are the advantages of "cemented" versus "cementless" fixation methods?

"Cemented" fixation provides immediate stability because the bone cement fills the gaps and hardens, securing the implant quickly, which is advantageous in cases with compromised bone quality, where immediate stability is important. "Cementless" fixation relies on bone integration, where the bone grows into the implant’s surface over time. This results in a stronger, more durable fixation that is favored for long-term biologic fixation. The specific needs of the patient and the surgical situation dictates the choice.

How should a surgeon decide between "cemented" and "cementless" components during a joint replacement revision?

The choice between "cemented" and "cementless" components should be based on various factors, including bone quality, the presence of infection, and the patient’s overall health. While current literature does not definitively support one method over the other for infection cure rates, the mode of fixation, and the potential for adding antibiotics with "cemented" components, and the ability to remove "cementless" components easily, are significant considerations. Consulting with an experienced orthopedic surgeon and considering the latest research will help ensure the best possible outcome.