Cementlös

Cementlös is the Swedish term for cementless, a method for fixing implants or prostheses to bone without bone cement. Instead of relying on polymethyl methacrylate (PMMA) cement, cementless devices depend on an initial mechanical fit and subsequent biological fixation through bone ingrowth (osseointegration).

Mechanisms: The implant is designed to achieve a secure press-fit within the bone, often with a porous or roughened surface, sometimes coated with hydroxyapatite or porous titanium. Over weeks to months, bone grows into the surface, converting mechanical stability into biological fixation. The implant design may include screws or pegs to enhance initial stability.

Applications: In orthopedics, cementless fixation is common in hip and knee arthroplasty, particularly in younger, more active patients. Cementless stems and shells rely on bone ingrowth for long-term fixation. In dentistry, many dental implants are placed cementlessly; osseointegrated root-like implants anchor crowns or prostheses without cement, typically over several months of healing.

Advantages and limitations: Advantages include avoidance of cement-related debris, potentially durable long-term fixation in good bone, and considerations that can simplify certain revisions. Limitations include dependence on bone quality (osteoporotic bone may not support secure fixation), longer initial healing time, and higher demands on surgical technique and implant design. Early loosening is a concern if initial stability is insufficient.

Status and trends: Cementless fixation remains a major option in contemporary musculoskeletal and dental implantology, with ongoing research into surface coatings, porous architectures, and patient-specific strategies.