The Important Role and Choice of Cement Restrictor

Heisel, Christian; Breusch, Steffen

doi:10.1007/3-540-28924-0_18

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Studies comparing these biodegradable plugs with the conventional polyethylene plugs have shown that the biodegradable plugs are less competent to intra-medullary pressures and are associated with higher rates of migration. 11,18 PMMA plugs of certain designs have been reported to perform better than the polyethylene and the gelatine plugs in some studies, 7,14,15 however, their performance was dependent on the flexibility and elasticity of the specific plug. Some PMMA plugs like the Palacos plug (Merck Biomaterial, Germany) are rigid and non-flexible and have been shown not to sufficiently occlude the canal.…”

Section: Discussionmentioning

confidence: 99%

“…Some PMMA plugs like the Palacos plug (Merck Biomaterial, Germany) are rigid and non-flexible and have been shown not to sufficiently occlude the canal. 7 Specifically, when the canals are distally expanding or the plug is to be placed distal to the isthmus, these rigid PMMA plugs were associated with significant migration and cement leakage distally, whereas the flexible plugs like the PMMA Exeter plug (Stryker Howmedica, Mahwah, NJ, USA) and the gelatine plugs could conform to the dimensions of the canal. PMMA plugs are directly in contact with the cement and can be drilled through at the time of revision and do not add significant difficulty at the time of revision.…”

Section: Discussionmentioning

confidence: 99%

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Canal occlusion in cemented primary total hip replacement: autologous compacted bone block compared to a commercially available gelatine plug

et al. 2019

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Aims: To evaluate the stability of 2 canal occlusion systems; an autologous, compacted bone block and the biodegradable C-plug. We also sought to investigate any relationship between stability of the systems and the quality of cementation. A retrospective radiographic comparative review was conducted. Methods: A total of 203 consecutive patients were analysed, 89 received an autologous bone block and 114 had C-plugs. There was no significant differences between the groups in terms of age, sex and primary diagnosis. The mean cement tail length in the bone block group (6.42 mm; range 0–31) was significantly shorter than in the C-plug group (17.11 mm; range 0–65.7). Results: The proportion of patients with good quality of cementation (Barrack grade A) was significantly higher in the bone block group (80.6%) as compared to the C-plug group (56%) ( p < 0.001). There was a negative correlation between the length of the cement tail and the Barrack grade, indicating that a short cement tail is associated with better quality cementation. Conclusions: We have shown that improved cement penetration and shorter cement tails can be achieved with the cheapest of all options for canal occlusion, an autologous compacted bone block and hence recommend this technique.

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