Acetabular Fixation Options: Notes from the Other Side

The basis of cement fixation is the interdigitation of cement into the cancellous bone while being supported by the cortical bone. If this is achieved, socket fixation is durable for 10 to 15 years. Cementless socket fixation using a titanium hemispherical socket with a porous surface has had excellent clinical results. Titanium fibermesh cups with supplemental screw fixation have the longest published results for uncemented sockets, with a survivorship of 99% using fixation failure as the end point. Similar findings at 8- to 10-year follow-up have been shown for sintered bead surfaces, as well as plasma spray surfaces, with and without hydroxyapatite coating. Regardless of the fixation technique chosen, a physical, 3-dimensional interlocking between the socket and the supporting bone is necessary for long-term fixation.