1220 THE JOURNAL OF BONE AND JOINT SURGERY Histomorphological Studies of the Long-Term Skeletal Responses to Well Fixed Cemented Femoral Components*

ABSTRACT: Thirteen femora that were obtained at autopsy from patients in whom a cemented total hip replacement had been implanted from forty months to 17.5 years earlier were evaluated radiographically and morphologically. All ofthe patients had been functioning well, and only one of the prostheses showed radiographic evidence of loosening. Serial sections of the proximal portion of the femur that enclosed the femoral component of the prosthesis showed that the host bone was intimately and directly apposed to the cement, and fibrous tissue intervened only rarely. The bone-remodeling processes had created a dense shell of substantial new bone around the cement-mantle that resembled a new cortex, attached to the outer cortex by new trabecular struts. Evidence of in