Aseptic loosening of uncemented femoral components in long-term hemodialysis patients: a systematic review of the literature

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The purpose of this study was to determine if reliable cementless fixation in hip arthroplasty can be achieved in patients on long-term hemodialysis.


A systematic review was conducted with an emphasis on aseptic loosening of femoral components in total hip arthroplasty and hemiarthroplasty. Studies were analyzed using the Methodological Index for Nonrandomized Studies (MINORS) instrument and the Center for Evidence-Based Medicine’s Levels of Evidence Scale. Six lower-quality cases series were included.


Rates of radiographic evidence of loosening and revision caused by aseptic loosening ranged from 0% to 100%. Data pooling could not be performed because of heterogeneity of the studies included.


It appears that patients with end-stage renal disease have bone stock suitable for cementless fixation. However, the varying outcomes reported in the literature reflect that the factors leading to early loosening of femoral components in dialyzed patients still remain unclear.

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