Which patient profile is more likely to receive a cemented hip stem due to reliable immediate stability?

• A. Younger with good bone stock
• B. Older or osteoporotic bone
• C. Very active athletes
• D. Prior infection

Answer: (B)

Immediate stability with a cemented hip stem comes from the cement mantle acting like grout between the stem and the bone, locking the components in place right away and reducing micromotion. In older patients or those with osteoporosis, bone quality is poor and cannot reliably provide the press-fit fixation that cementless stems rely on for long-term fixation. The cemented approach compensates for this by filling irregularities and distributing loads through the cement mantle, giving predictable, immediate stability even in fragile bone. In contrast, younger patients with good bone stock are more suited to cementless stems that rely on bone ingrowth for fixation over time, which is why cemented stems aren’t as necessary in that group. Prior infection affects management decisions differently and is not primarily about achieving immediate mechanical stability, though infection considerations can influence the overall choice of fixation type.