Are total hip prostheses implanted with the use of methylmethacrylate biocompatible?

Objectives: The biocompatibility of total hip replacement prostheses and methylmethacrylate cement which is used for fixation of the prosthetic components has been subject to debate for three decades.

Methods: We have studied the host response to total hip replacement prostheses in a number of clinical and experimental investigations.

Results: Methylmethacrylate cement is immunologically relatively inert while it causes, in in vitro experiments and in vivo, a foreign body type of reaction. In cementless prostheses, the wear of polyethylene which is used for lining of the acetabular component causes a similar foreign body type of reaction.

Conclusion: Ultimately, the total hip prosthesis cannot be made invisible to the host system. The host response can be controlled and reduced, but not eliminated by technical improvement and development of more biocompatible materials.