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The first clinical results of the Lindenhof ceramic-metal composite prosthesis implanted in our hospital in Freiburg are presented. We observed that same favorable early results as the conventional prostheses in a correct position. The implants are incorporated into the bone within 8-12 weeks. The radiographic films show the adaptation of the supporting bone around the ceramic socket. We explain the failures due to our initial lack of technical experience and/or anatomical deformation of the pelvic bone. complications caused by the post-operative treatment during the 12 weeks following surgery did not occur. The combination of a cemented metal femoral component with a ceramic head seems to be a reasonable compromise to use the favorable physical and biochemical properties of the bioceramic material as long as there is no satisfactory solution for a stable cementless fixation of the femoral stem in to the bone. The advantages of the Lindenhof prosthesis predominate the disadvantages: expensive instruments and a post-operative treatment of several months.

Uncemented total hip replacements have resulted in a higher incidence of postoperative complaints than cemented ones. The theoretical explanation of these not well defined discomforts is based on the differences of the stress and strain fields around the distal portions of the femoral components. While the noncemented stems are press-fitted and most of them tapered distally, thus creating hoop stresses and strains in the surrounding cortical bone, the shrinkage of the cement prevents these mechanical irritations. The relatively sudden disappearance of these discomforts within the first 2 postoperative years is attributed to the shift of the main zone of load transmission from the distal to the proximal portion of the stems following bone remodeling.

The results show that Indomethacin-Short-Term-Therapy as well as Single-Dose-Radiatio with 6 Gy can reliably prevent the occurrence of severe PAO. Both therapeutic concepts therefore can be employed as prophylaxis in primary endoprosthetic operations. The choice between the two procedures will then mainly be determined by given logistic conditions in the clinic, specific contraindications of the patient and financial considerations.