Which statement best describes the overall longevity of cemented versus cementless hip stems?

• A. Cemented stems last longer
• B. Cementless stems last longer
• C. Longevity is similar overall
• D. Cementless has much easier revisions

Answer: (C)

In hip arthroplasty, the long-term durability of the stem comes from how it is fixed and how the bone interacts with it, plus patient factors. Cemented stems use a cement mantle to secure the prosthesis, giving reliable immediate fixation, especially in older patients with softer bone. Cementless stems rely on a tight press-fit and bone ingrowth into a porous surface, which tends to favor younger, more active patients with good bone quality. When looking at large groups over many years, the revision rates due to stem failure end up similar for both approaches. Different scenarios show different strengths, but overall, the longevity ends up comparable, which is why the statement that longevity is similar overall is considered the best answer.