title: Cement-within-cement revision hip arthroplasty; should it be done?
abstract: 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.
authors.affiliation: Broomfield Hospital, Chelmsford, England, UK.
authors.forename: P L
authors.initials: PL
authors.lastname: Li
authors.forename: P J
authors.initials: PJ
authors.lastname: Ingle
authors.forename: J K
authors.initials: JK
authors.lastname: Dowell
mesh_terms: 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
chemical_list: D001843:Bone Cements