(Acetabular 0.2%, Femoral 0/2000 HRA, 0/1000 THR)

Implants need to be firmly attached to bone to function correctly. If they are loose, they rub on the bone causing pain. There are two methods to fix implants to bone: cementing and bone ingrowth. The advantage of cement is immediate fixation, while the disadvantage is lower durability. I strongly favor bone ingrowth implants. The disadvantage they have is a low rate of bone ingrowth failure. Most US surgeons favor bone ingrowth in THA except possibly in very old weak bone, where cement may still have an advantage.

Approximately 90% of all THR implants are bone ingrowth types. The socket component that I use for HRA and THR are the same. We had some problems with bone ingrowth failures in dysplasia case with severely deformed anatomy before 2007. However, since then the introduction of a component with supplemental fixation (Trispike Magnum) that we can use in these deformed cases, has allowed us to decrease the rate of acetabular bone ingrowth failure to 0.2%. We have not had any failure of bone ingrowth into the uncemented femoral component in HRA or THR in 5 years.