Radiologic Evaluation of the Cement Mantle in the Femoral Shaft. A Comparative Study Using a Fast-Set or a Standard-Set Cement

Gallart, Xavier; Martínez, Fredy Hermógenes Prada; García, Samuel; Riba, Josep; Combalía, Andrés; Ballesteros, José R.; Elefante, F.; Calonego, Giovanni

doi:10.1177/112070000701700403

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“…The patients received a standard collarless cemented Corail hip stem with standard offset, a 28 mm Alumina Biolox Forte Ceramic Head (DePuy Synthes), and a cemented polyethylene Marathon acetabular component (DePuy Synthes). Cemex Genta Fast Bone Cement (Tecres, Italy) 21 - 25 was inserted using a third-generation cementing technique with pulsatile lavage and closed mixing, retrograde injection, proximal seal, and pressurization. The cement was inserted at two minutes and the stems implanted at three minutes after mixing, respectively.…”

Section: Methodsmentioning

confidence: 99%

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Sevaldsen

Husby

Lian

et al. 2022

The Bone & Joint Journal

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Aims Highly polished stems with force-closed design have shown satisfactory clinical results despite being related to relatively high early migration. It has been suggested that the minimal thickness of cement mantles surrounding the femoral stem should be 2 mm to 4 mm to avoid aseptic loosening. The line-to-line cementing technique of the femoral stem, designed to achieve stem press-fit, challenges this opinion. We compared the migration of a highly polished stem with force-closed design by standard and line-to-line cementing to investigate whether differences in early migration of the stems occur in a clinical study. Methods In this single-blind, randomized controlled, clinical radiostereometric analysis (RSA) study, the migration pattern of the cemented Corail hip stem was compared between line-to-line and standard cementing in 48 arthroplasties. The primary outcome measure was femoral stem migration in terms of rotation and translation around and along with the X-, Y-, and Z- axes measured using model-based RSA at three, 12, and 24 months. A linear mixed-effects model was used for statistical analysis. Results Results from mixed model analyses revealed a lower mean retroversion for line-to-line (0.72° (95% confidence interval (CI) 0.38° to 1.07°; p < 0.001), but no significant differences in subsidence between the techniques (-0.15 mm (95% CI -0.53 to 0.227; p = 0.429) at 24 months. Radiolucent lines measuring < 2 mm wide were found in three and five arthroplasties cemented by the standard and line-to-line method, respectively. Conclusion The cemented Corail stem with a force-closed design seems to settle earlier and better with the line-to-line cementing method, although for subsidence the difference was not significant. However, the lower rate of migration into retroversion may reduce the wear and cement deformation, contributing to good long-term fixation and implant survival. Cite this article: Bone Joint J 2022;104-B(1):19–26.

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Section: Methodsmentioning

confidence: 99%

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Sevaldsen

Husby

Lian

et al. 2022

The Bone & Joint Journal

View full text Add to dashboard Cite

show abstract

Radiologic Evaluation of the Cement Mantle in the Femoral Shaft. A Comparative Study Using a Fast-Set or a Standard-Set Cement

Abstract: The use of fast or standard setting cement does not produce any difference in the quality of the radiologic cement mantle in the short-term. Both cements comply with ISO 5833 requirements.

Cited by 1 publication

References 21 publications

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

Is the French Paradox cementing philosophy superior to the standard cementing? A randomized controlled radiostereometric trial and comparative analysis

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