Before surgery, the surgeon will decide whether to use cemented or uncemented joints based on your age and how your X-rays look. Or, the surgeon may decide at the time of surgery, when he or she opens up the joint and can see how the bone looks. One type is not clearly better than the other. Doctors may be more likely to use uncemented joints in younger people whose bone is in good condition and likely to make a strong bond with the replacement component. They may use cemented joints in older people or those whose bone is weaker and less likely to make a strong bond with the replacement components.

Cemented joints form an immediate, strong bond to the bone but often loosen after 10 to 20 years. A cemented bond is strongest immediately after surgery and gets weaker over time. In contrast, uncemented joints form a bond that may be weaker at first but may form a strong permanent bond as the bone fills in the porous coating. Once a strong bond has developed between the bone and the replacement components, uncemented joints are less likely to weaken or loosen over time. Most loosening that can be seen on an X-ray doesn't cause symptoms and is not a problem.