Advantages of cemented stems in facilitating early postoperative rehabilitation after total hip arthroplasty: a propensity score-matched analysis

Abstract

Purpose:

This study examined whether cemented stems in total hip arthroplasty (THA) accelerate postoperative rehabilitation compared to cementless stems, even in patients with osteoporosis.

Methods:

A retrospective analysis of 232 unilateral THAs included cemented (n = 84) and cementless (n = 148) groups. Propensity score matching yielded 53 matched pairs. Outcomes included rehabilitation milestones (initiation of T-cane walking, stable ambulation, and stair climbing), length of hospital stay, and clinical scores. Perioperative parameters, such as operative time, blood loss, and pain scores were also assessed.

Results:

The cemented group achieved earlier initiation (4.2 ± 2.4 vs. 5.2 ± 2.6 days, respectively; p < 0.05) and stabilisation (5.3 ± 3.1 vs. 6.6 ± 3.4 days, p < 0.05) of T-cane walking compared to the cementless group. No significant differences were observed in stair-climbing time or length of hospital stay. Despite greater intraoperative blood loss in the cemented group, the estimated total and postoperative blood losses were comparable. Both groups showed similar improvements in clinical scores over 12 months.

Conclusions:

Cemented stems facilitated earlier ambulation without compromising long-term outcomes, supporting their use in osteoporotic patients for early postoperative recovery.