Cement-within-cement revision hip arthroplasty; should it be done?
The complete removal of the cement mantle at revision arthroplasty can be extremely difficult. Some authors advise a 'cement-within-cement' revision technique in which a new layer of cement is applied to the old before insertion of the femoral component. We could find no long-term clinical data regarding the success of this procedure. In a simple biomechanical study, we examined the strength of the cement-to-cement interface in conditions likely to prevail in vivo. We found that the presence of a thin layer of blood and marrow debris at the interface weakened the cement-to-cement bond by 80% to 85%. These biomechanical findings and additional photomicrographic evidence do not support the practice of cement-within-cement revision arthroplasty.
Li
P L
PL
Broomfield Hospital, Chelmsford, England, UK.
Ingle
P J
PJ
Dowell
J K
JK
D001843:Bone Cements / Q000627:therapeutic use*; D006622:Hip Prosthesis / Q000379:methods*; D006801:Humans; D008422:Materials Testing; D010784:Photomicrography; D012086:Reoperation / Q000379:methods; D013314:Stress, Mechanical; D013718:Tensile Strength
D001843:Bone Cements