Choosing the correct type of hip replacement is important as there are many types, often with their own advantages and disadvantages.
Cemented hip replacements are relatively simple and forgiving to use and have excellent results in many patients. They are the least likely type to fail early but will not last forever. That is not to say that there are not plenty of cemented hips in existence that have lasted twenty five years or more.
Uncemented hip replacements are rising in popularity in the United Kingdom. They allow the surgeon to vary the position of implants with a little more control than cemented designs and can allow for the use of different bearing surfaces (such as ceramic hips - see below). They have the potential to last for a very long time. They need to be inserted with more force than cemented hips and may not be the most suitable choice in patients with brittle bones, such as osteoporosis sufferers.
Metal on plastic hip replacements have stood the test of time and can be implanted with either a cemented total hip replacement or uncemented total hip replacement technique. They are a very useful option in cases where the hip has a deformity present as they can be adjusted to reduce rates of dislocation. Mr Miles uses metal on plastic hips with a variety of potential enhancements, including treatment to make the plastic more durable and special cups which improve the stability called duomobility sockets.
Ceramic is much harder than metal or plastic so wears out at an almost imperceptibly slow rate. It is, however, easier to fracture so may not be appropriate for patients who do impact sports. It is also more susceptible to dislocation and must be implanted very accurately to minimise the risk. It is useful in very young patients in whom softer materials may wear out more quickly.