Femoral cement within cement technique in carefully selected aseptic revision arthroplasties

Abstract

The aim of this study was to evaluate the clinical and radiological results in a group of patients who underwent aseptic revision hip arthroplasty using the cement within cement (CWC) technique. Between 1999 and 2005, 37 aseptic revision hip operations were performed. There were 30 women and five men, with an average age of 68 years. The reasons for revision were femoral stem fracture, cup failure, acetabular protrusion after hemiarthroplasty and recurrent dislocation. At an average follow-up of 46 months, none of the patients required further femoral revision. The average post-operative Merle D'Aubigne score was 16.6 points (p<0.05). No evidence of radiological stem failure was observed and no femoral component was considered to be at risk for loosening. In this series of patients, the CWC technique provided consistent with high functional outcomes. This valid and effective alternative should be considered in carefully selected aseptic cases.

Cement-in-cement femoral revisions using a specially designed polished short revision stem; 24 consecutive stems followed for five to seven years

“…The offset of 44 mm is attractive as most slim standard implants which are available on the market (which could be used for the same application) have smaller offsets related to the stem size, and using these stems for cement-in-cement revisions can result in higher dislocation rates. In our study the dislocation rate (we had one recurrent dislocator, 4%) was similar to other cement-in-cement studies and less than revision of total hip prosthesis in general (4–5–6, 8, 9). In addition, it is easy to change the stem position to more or less anteversion while doing revisions in recurrent dislocators.…”

“…In cases with an intact femoral cement mantle, a cement-in-cement revision is attractive (1, 4, 5, 7–8–9). However, most standard cement stems including the traditional Exeter Universal tapered stem are too long to fit in the existing cement mantle.…”

“…Greenwald et al (3) were the first to examine biomechanically the cement-in-cement technique, in which a new prosthesis is recemented within the old cement mantle. Clinical studies of this cement-in-cement technique with short to medium term follow-up have shown very few femoral re-revisions for aseptic loosening and have supported the use of this technique in femoral revision surgery, provided the cement mantle is well fixed radiologically and intra-operatively (1, 4–5–6–7–8–9).…”

The use of femoral struts and impacted cancellous bone allograft in patients with severe femoral bone loss who undergo revision total hip replacement

“…A long cemented stem bypassing the fracture was introduced using the in-cement technique preserving the proximal cement mantle. 23 The mean functional score at final follow-up was 17.3 points (16 to 18). Four patients had pain at the lateral aspect of the thigh due to protrusion of the strut and pressure on vastus lateralis, which had disappeared after six months' follow-up in all four cases.…”

Revision total hip arthroplasty: the femoral side using cemented implants

“…The Kaplan Meier survival for this group was therefore 100% (95% CI 91.4-100). The survival rate for revision for all Marcos et al reported clinical and radiological outcomes using the cement-in-cement femoral revision technique [9]. Between 1999 and 2005, 37 aseptic revision procedures were performed in 35 patients with an average age of 68 years.…”