human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We selected r and omly a consecutive series of 162 patients requiring hip replacement to receive either a cementless , hemispherical , modular , titanium acetabular cup or a cemented , all-polyethylene cup . These replacements were performed by two surgeons in four general hospitals . The same surgical technique was used and a 26 mm metal-head femoral component was used in every case . After exclusions , 115 hips were studied for differences in rates of wear and osteolysis . The mean clinical follow-up was eight years and the mean radiological follow-up , 6.5 years . The cementless cups  wore at a mean rate of 0.15 mm per year and the cemented cups at 0.07 mm per year . This difference was significant ( p < 0.0001 ) . Our findings in this mid-term study suggest that cementless cups  wear more than cemented cups UNLABELLED The current study was performed to determine the status , at a minimum of twenty-five years , of a prospect i ve , single-surgeon series of patients treated with primary Charnley total hip arthroplasty with a contemporary femoral cementing technique that included use of a distal cement plug and a retro grade cement-delivery system . Since our review at a minimum of twenty years postoperatively , two primary total hip prostheses were revised ( one because of acetabular loosening , and one because of femoral loosening ) . Of the original cohort of 357 hips ( 320 patients ) , ten ( 2.8 % ) had revision of the femoral stem because of aseptic loosening . Forty-nine patients ( fifty-two hips , 14.6 % ) who had been in the initial study group were still living at the time of the present review . Five hips ( 10 % ) in living patients had required a femoral revision because of aseptic loosening . Including those that were revised , eight femoral components ( 17 % ) in living patients were seen to be loose radiographically . Although this study demonstrates the remarkable durability of the femoral fixation obtained with the polished flatback Charnley prosthesis and the contemporary cementing technique , there was some deterioration of the results with time . These results provide a st and ard for comparison with cementless fixation after hips treated with that technique have been followed for a similar duration . LEVEL OF EVIDENCE Therapeutic Level IV . See Instructions to Authors for a complete description of levels of evidence OBJECTIVE To determine the prevalence of heterotopic bone formation in cemented versus noncemented total hip joint replacement . DESIGN A prospect i ve r and omized controlled trial . Follow-up ranged from 2 to 6 years ( mean 4 years ) . SETTING A university hospital . PATIENTS Two hundred and twenty-six patients who had primary or secondary osteoarthrosis of the hip were stratified according to type of fixation , surgeon and age . Patients were r and omized within strata : 112 received noncemented total hip prostheses and 114 received cemented prostheses . The 2 groups were similar with respect to age and sex . INTERVENTION Primary total hip arthroplasty . A cemented ( methylmethacrylate ) or noncemented prosthesis was inserted by a lateral surgical approach . MAIN OUTCOME MEASURE The Brooker classification was used to grade heterotopic bone formation from postoperative radiographs . RESULTS Overall , 148 ( 66 % ) hips had no heterotopic ossification , 56 ( 25 % ) were Brooker class I , 14 ( 6 % ) were class II , 8 ( 3 % ) were class III and none were class IV . In the noncemented group of patients , 76 ( 68 % ) hips had no heterotopic ossification , 25 ( 22 % ) were Brooker class I , 7 ( 6 % ) were class II , 4 ( 4 % ) were class III and none were class IV . In the cemented group of patients , 72 ( 63 % ) hips had no heterotopic ossification , 31 ( 27 % ) hips were Brooker class I , 7 ( 6 % ) were class II , 4 ( 4 % ) were class III and none were class IV . CONCLUSION There was no significant difference in the prevalence of heterotopic ossification between cemented and noncemented total hip replacements in patients with osteoarthrosis This study compares cemented ( Charnley ) with noncemented ( Honart Patel-Garches ) total hip arthroplasty . 150 patients with osteoarthritis , rheumatoid arthritis , and miscellaneous conditions were r and omized into either group with 75 in each . Patients were evaluated over 5 postoperative years with examinations at 6 months , at 1 year , and then annually . Each examination involved clinical assessment , objective gait analysis , and radiographic examination . The Charnley group improved faster than the HP-Garches group during the first 2 years . At the last evaluation the results were excellent or good in 79 % in the Charnley group and 70 % in the HP-Garches group . In the HP-Garches group midthigh pain occurred in 64 % . Five patients with Charnley prostheses ( 6.7 % ) and 14 patients with HP-Garches prostheses ( 18.7 % had revision surgery to correct mechanical loosening . St and ard radiography revealed radiolucent zones in both groups , but this could not be related to the clinical outcome despite radiolucency being present in all noncemented replacements on the femoral side . Objective gait analysis confirmed inferior clinical results at 6 months in the HP-Garches group . There was no significant difference between the groups at the most recent evaluation . Our findings are not consistent with earlier optimistic expectations on press-fit noncemented total hip arthroplasties In a r and omized clinical trial of cemented and cementless total hip arthroplasty , 147 patients ( 76 cemented , 71 cementless ) have had a minimum 4-year clinical and radiographic follow-up evaluation . No revisions have been done in either group . Two cemented acetabular components were considered definitely loose and 18 were probably loose ; 7 cemented stems were possibly loose at last follow-up examination . One cementless socket was considered unstable . Although cementless femoral component subsidence occurred in 10 cases , the sinkage always stabilized within 6 months , and no stem was considered unstable at last follow-up examination . Significant femoral bone resorption was rare , and so-called " spot welds " were uncommon using this titanium stem .  Distal cortical hypertrophy was common , but the cause is uncertain . Osteolysis was seen around 10 cementless and 6 cemented sockets . A small area of lysis occurred in the proximal medial femoral neck in 15 cemented stems and 1 cementless stem . No cases of distal femoral lysis were seen in either group . Despite excellent clinical results with no difference between groups , the high rate of early radiographic failure of this metal-backed acetabulum should preclude its use . Osteolysis will continue to be a problem in both groups , and its prevention should remain the focus of future studies In a prospect i ve study , 93 unselected consecutive uncemented hip arthroplasties were performed in 80 patients using the  titanium-coated RM acetabular component and the CLS femoral component .  The mean age of the patients at operation was 52 years ( 28 to 81 ) . None were lost to follow-up . In the 23 patients who had died ( 26 hips ) only one acetabular component had been revised . In the 57 living patients ( 67 hips ) , 13 such revisions had been performed . Of the 14 revisions , seven were for osteolysis , five for loosening and two for infection . Survival analysis of this implant showed a total probability of survival of 83 % ( 95 % confidence interval 73 to 90 ) , with all revisions as the endpoint , and a probability of 94 % ( 95 % confidence interval 87 to 98 ) with revision for aseptic loosening as the endpoint , indicating reliable long-term fixation of the titanium-coated RM acetabular component The purpose of the current study was to up date the results of a prospect i ve , single-surgeon series of primary Charnley total hip arthroplasties performed with cement . This investigation is one of the first studies in which hips treated with total hip arthroplasty with cement  were followed for a minimum of thirty years . Twenty-seven patients ( thirty-four [ 10.3 % ] of the hips in the initial study group ) were alive at a minimum of thirty years postoperatively . These patients served as the focus of the present study .  Revision because of aseptic loosening of the acetabular component was performed in 7.3 % ( twenty-three ) of the hips from the original study group ( excluding those revised because of infection or dislocation ) and 26 % ( eight ) of the hips in the living cohort .  Revision  because of aseptic loosening of the femoral component was performed in 3.2 % ( ten ) of the hips from the original study group ( excluding those revised because of infection or dislocation ) and 10 % ( three ) of the hips in the living patients . Since the twenty-five-year review , three hips were revised ( one because of acetabular loosening , one because of femoral loosening , and one because of instability ) . This end- result study demonstrated the remarkable durability of cemented Charnley total hip replacements over a span of three decades , with 88 % of the original prostheses intact at the time of the final follow-up or at the patient 's death Abstract The results of 498 total hip arthroplasties were prospect ively studied . In 329 patients a cemented acetabular polyethylene cup was inserted . In 169 patients a threaded socket without cement was introduced . Follow-up ranged from 6 to 8 years and follow-up rate was over 90 % . Of the 169 threaded sockets 8 required revision ( 4.7 % ) , and 3 acetabular components were seen to be loose on X-ray . Of the cemented cups , only 2 ( 0.6 % ) required revision and none were considered loose on X-ray . Résumé Présentation d’une étude prospect i ve de 498 arthroplasties totale de la hanche . Dans 329 cas , une cupule en polyéthylène cimentée a été utilesée . Dans 169 cas , un cotyle sans ciment vissé a été utilisé . 90 % des patients ont été suivis 6 à 8 ans . Parmi les 169 cupules vissées , 11 sont descellées et 8 ont dûêtre révisées ( 4,7 % ) . Il n’y a que 2 descellements des cupules cimentées qui ont dûêtre révisés ( 0,6 % ) A prospect i ve , r and omized , double-blind , clinical trial comparing cemented with cementless total hip arthroplasty  was performed to compare the prevalence and pattern of acetabular osteolysis . Both groups were similar before surgery . Acetabular components were metal-backed , titanium implants . Twenty-eight-millimeter modular femoral heads with titanium femoral stems were used . At a minimum 2-year and mean 4-year follow-up period ( range , 2 - 6 years ) , 224 patients had clinical and radiographic data available . There was no significant difference in the prevalence of acetabular osteolysis between cemented ( 5 % ) and cementless ( 9 % ) fixation . With or without cement , the use of a titanium femoral head led to osteolysis within a relatively short period after surgery in almost all of the cases , although this was not significant . The pattern of acetabular osteolysis was different . Progressive osteolysis occurred predominantly in acetabular zone 1 in the cemented group and zone 2 in the cementless group . Cementless fixation of acetabular components has been advocated in an attempt to minimize osteolysis that may occur in cemented total hip arthroplasty . This study found no difference in the prevalence of acetabular osteolysis between the two groups THR has become one of the most widely performed operations in orthopaedic surgery . In Germany , more than 180,000 THRs are currently done annually with increasing tendency . We use four different types of endoprostheses : ( 1 ) cemented , ( 2 ) cement-less , ( 3 ) hybrid ( cement-free implanted socket and cemented stem ) , and ( 4 ) hemi-endoprosthesis ( cemented stem without socket ) . A total number of 600 patients were included in a prospect i ve follow-up study during 5 to 20 years , with a mean follow-up period of 10 years . The relevant question of whether to use a cemented , hybrid , or cement-free version of THR is , in our opinion , no longer a concern . All the methods have their advantages , disadvantages , indications , and contraindications . After the " Endler-era " , significant differences are not noted between the groups of cemented , hybrid , and cement-less implants that impact on the clinical results and loosening rates Ninety patients ( 96 hips ) scheduled for THA were stratified to fixation of the acetabular component in three main groups of about equal size . Fluoride cement , porous coated press-fit cup with ceramic coating or Palacos cum Gentamicin cement were used . All patients received Spectron EF stem .  The migration of the cups and the femoral head penetration into the socket were measured with radiostereometric analysis . At 2 years the choice of fixation did not influence the migration or rotation of the cup . 
    Output:
    
agent
A best evidence analysis for complications , wear , osteolysis , migration and clinical scores showed no superiority for either cemented or cementless socket in the RCTs .
A best evidence analysis for non RCT studies revealed better osteolysis , migration properties and aseptic loosening survival for cementless sockets ; however , wear and overall survival favoured the cemented sockets .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We selected r and omly a consecutive series of 162 patients requiring hip replacement to receive either a cementless , hemispherical , modular , titanium acetabular cup or a cemented , all-polyethylene cup . These replacements were performed by two surgeons in four general hospitals . The same surgical technique was used and a 26 mm metal-head femoral component was used in every case . After exclusions , 115 hips were studied for differences in rates of wear and osteolysis . The mean clinical follow-up was eight years and the mean radiological follow-up , 6.5 years . The cementless cups  wore at a mean rate of 0.15 mm per year and the cemented cups at 0.07 mm per year . This difference was significant ( p < 0.0001 ) . Our findings in this mid-term study suggest that cementless cups  wear more than cemented cups UNLABELLED The current study was performed to determine the status , at a minimum of twenty-five years , of a prospect i ve , single-surgeon series of patients treated with primary Charnley total hip arthroplasty with a contemporary femoral cementing technique that included use of a distal cement plug and a retro grade cement-delivery system . Since our review at a minimum of twenty years postoperatively , two primary total hip prostheses were revised ( one because of acetabular loosening , and one because of femoral loosening ) . Of the original cohort of 357 hips ( 320 patients ) , ten ( 2.8 % ) had revision of the femoral stem because of aseptic loosening . Forty-nine patients ( fifty-two hips , 14.6 % ) who had been in the initial study group were still living at the time of the present review . Five hips ( 10 % ) in living patients had required a femoral revision because of aseptic loosening . Including those that were revised , eight femoral components ( 17 % ) in living patients were seen to be loose radiographically . Although this study demonstrates the remarkable durability of the femoral fixation obtained with the polished flatback Charnley prosthesis and the contemporary cementing technique , there was some deterioration of the results with time . These results provide a st and ard for comparison with cementless fixation after hips treated with that technique have been followed for a similar duration . LEVEL OF EVIDENCE Therapeutic Level IV . See Instructions to Authors for a complete description of levels of evidence OBJECTIVE To determine the prevalence of heterotopic bone formation in cemented versus noncemented total hip joint replacement . DESIGN A prospect i ve r and omized controlled trial . Follow-up ranged from 2 to 6 years ( mean 4 years ) . SETTING A university hospital . PATIENTS Two hundred and twenty-six patients who had primary or secondary osteoarthrosis of the hip were stratified according to type of fixation , surgeon and age . Patients were r and omized within strata : 112 received noncemented total hip prostheses and 114 received cemented prostheses . The 2 groups were similar with respect to age and sex . INTERVENTION Primary total hip arthroplasty . A cemented ( methylmethacrylate ) or noncemented prosthesis was inserted by a lateral surgical approach . MAIN OUTCOME MEASURE The Brooker classification was used to grade heterotopic bone formation from postoperative radiographs . RESULTS Overall , 148 ( 66 % ) hips had no heterotopic ossification , 56 ( 25 % ) were Brooker class I , 14 ( 6 % ) were class II , 8 ( 3 % ) were class III and none were class IV . In the noncemented group of patients , 76 ( 68 % ) hips had no heterotopic ossification , 25 ( 22 % ) were Brooker class I , 7 ( 6 % ) were class II , 4 ( 4 % ) were class III and none were class IV . In the cemented group of patients , 72 ( 63 % ) hips had no heterotopic ossification , 31 ( 27 % ) hips were Brooker class I , 7 ( 6 % ) were class II , 4 ( 4 % ) were class III and none were class IV . CONCLUSION There was no significant difference in the prevalence of heterotopic ossification between cemented and noncemented total hip replacements in patients with osteoarthrosis This study compares cemented ( Charnley ) with noncemented ( Honart Patel-Garches ) total hip arthroplasty . 150 patients with osteoarthritis , rheumatoid arthritis , and miscellaneous conditions were r and omized into either group with 75 in each . Patients were evaluated over 5 postoperative years with examinations at 6 months , at 1 year , and then annually . Each examination involved clinical assessment , objective gait analysis , and radiographic examination . The Charnley group improved faster than the HP-Garches group during the first 2 years . At the last evaluation the results were excellent or good in 79 % in the Charnley group and 70 % in the HP-Garches group . In the HP-Garches group midthigh pain occurred in 64 % . Five patients with Charnley prostheses ( 6.7 % ) and 14 patients with HP-Garches prostheses ( 18.7 % had revision surgery to correct mechanical loosening . St and ard radiography revealed radiolucent zones in both groups , but this could not be related to the clinical outcome despite radiolucency being present in all noncemented replacements on the femoral side . Objective gait analysis confirmed inferior clinical results at 6 months in the HP-Garches group . There was no significant difference between the groups at the most recent evaluation . Our findings are not consistent with earlier optimistic expectations on press-fit noncemented total hip arthroplasties In a r and omized clinical trial of cemented and cementless total hip arthroplasty , 147 patients ( 76 cemented , 71 cementless ) have had a minimum 4-year clinical and radiographic follow-up evaluation . No revisions have been done in either group . Two cemented acetabular components were considered definitely loose and 18 were probably loose ; 7 cemented stems were possibly loose at last follow-up examination . One cementless socket was considered unstable . Although cementless femoral component subsidence occurred in 10 cases , the sinkage always stabilized within 6 months , and no stem was considered unstable at last follow-up examination . Significant femoral bone resorption was rare , and so-called " spot welds " were uncommon using this titanium stem .  Distal cortical hypertrophy was common , but the cause is uncertain . Osteolysis was seen around 10 cementless and 6 cemented sockets . A small area of lysis occurred in the proximal medial femoral neck in 15 cemented stems and 1 cementless stem . No cases of distal femoral lysis were seen in either group . Despite excellent clinical results with no difference between groups , the high rate of early radiographic failure of this metal-backed acetabulum should preclude its use . Osteolysis will continue to be a problem in both groups , and its prevention should remain the focus of future studies In a prospect i ve study , 93 unselected consecutive uncemented hip arthroplasties were performed in 80 patients using the  titanium-coated RM acetabular component and the CLS femoral component .  The mean age of the patients at operation was 52 years ( 28 to 81 ) . None were lost to follow-up . In the 23 patients who had died ( 26 hips ) only one acetabular component had been revised . In the 57 living patients ( 67 hips ) , 13 such revisions had been performed . Of the 14 revisions , seven were for osteolysis , five for loosening and two for infection . Survival analysis of this implant showed a total probability of survival of 83 % ( 95 % confidence interval 73 to 90 ) , with all revisions as the endpoint , and a probability of 94 % ( 95 % confidence interval 87 to 98 ) with revision for aseptic loosening as the endpoint , indicating reliable long-term fixation of the titanium-coated RM acetabular component The purpose of the current study was to up date the results of a prospect i ve , single-surgeon series of primary Charnley total hip arthroplasties performed with cement . This investigation is one of the first studies in which hips treated with total hip arthroplasty with cement  were followed for a minimum of thirty years . Twenty-seven patients ( thirty-four [ 10.3 % ] of the hips in the initial study group ) were alive at a minimum of thirty years postoperatively . These patients served as the focus of the present study .  Revision because of aseptic loosening of the acetabular component was performed in 7.3 % ( twenty-three ) of the hips from the original study group ( excluding those revised because of infection or dislocation ) and 26 % ( eight ) of the hips in the living cohort .  Revision  because of aseptic loosening of the femoral component was performed in 3.2 % ( ten ) of the hips from the original study group ( excluding those revised because of infection or dislocation ) and 10 % ( three ) of the hips in the living patients . Since the twenty-five-year review , three hips were revised ( one because of acetabular loosening , one because of femoral loosening , and one because of instability ) . This end- result study demonstrated the remarkable durability of cemented Charnley total hip replacements over a span of three decades , with 88 % of the original prostheses intact at the time of the final follow-up or at the patient 's death Abstract The results of 498 total hip arthroplasties were prospect ively studied . In 329 patients a cemented acetabular polyethylene cup was inserted . In 169 patients a threaded socket without cement was introduced . Follow-up ranged from 6 to 8 years and follow-up rate was over 90 % . Of the 169 threaded sockets 8 required revision ( 4.7 % ) , and 3 acetabular components were seen to be loose on X-ray . Of the cemented cups , only 2 ( 0.6 % ) required revision and none were considered loose on X-ray . Résumé Présentation d’une étude prospect i ve de 498 arthroplasties totale de la hanche . Dans 329 cas , une cupule en polyéthylène cimentée a été utilesée . Dans 169 cas , un cotyle sans ciment vissé a été utilisé . 90 % des patients ont été suivis 6 à 8 ans . Parmi les 169 cupules vissées , 11 sont descellées et 8 ont dûêtre révisées ( 4,7 % ) . Il n’y a que 2 descellements des cupules cimentées qui ont dûêtre révisés ( 0,6 % ) A prospect i ve , r and omized , double-blind , clinical trial comparing cemented with cementless total hip arthroplasty  was performed to compare the prevalence and pattern of acetabular osteolysis . Both groups were similar before surgery . Acetabular components were metal-backed , titanium implants . Twenty-eight-millimeter modular femoral heads with titanium femoral stems were used . At a minimum 2-year and mean 4-year follow-up period ( range , 2 - 6 years ) , 224 patients had clinical and radiographic data available . There was no significant difference in the prevalence of acetabular osteolysis between cemented ( 5 % ) and cementless ( 9 % ) fixation . With or without cement , the use of a titanium femoral head led to osteolysis within a relatively short period after surgery in almost all of the cases , although this was not significant . The pattern of acetabular osteolysis was different . Progressive osteolysis occurred predominantly in acetabular zone 1 in the cemented group and zone 2 in the cementless group . Cementless fixation of acetabular components has been advocated in an attempt to minimize osteolysis that may occur in cemented total hip arthroplasty . This study found no difference in the prevalence of acetabular osteolysis between the two groups THR has become one of the most widely performed operations in orthopaedic surgery . In Germany , more than 180,000 THRs are currently done annually with increasing tendency . We use four different types of endoprostheses : ( 1 ) cemented , ( 2 ) cement-less , ( 3 ) hybrid ( cement-free implanted socket and cemented stem ) , and ( 4 ) hemi-endoprosthesis ( cemented stem without socket ) . A total number of 600 patients were included in a prospect i ve follow-up study during 5 to 20 years , with a mean follow-up period of 10 years . The relevant question of whether to use a cemented , hybrid , or cement-free version of THR is , in our opinion , no longer a concern . All the methods have their advantages , disadvantages , indications , and contraindications . After the " Endler-era " , significant differences are not noted between the groups of cemented , hybrid , and cement-less implants that impact on the clinical results and loosening rates Ninety patients ( 96 hips ) scheduled for THA were stratified to fixation of the acetabular component in three main groups of about equal size . Fluoride cement , porous coated press-fit cup with ceramic coating or Palacos cum Gentamicin cement were used . All patients received Spectron EF stem .  The migration of the cups and the femoral head penetration into the socket were measured with radiostereometric analysis . At 2 years the choice of fixation did not influence the migration or rotation of the cup . 
    Output:
    