title: The cement mantle in the Exeter impaction allografting technique. A cause for concern.
abstract: The postoperative radiographs of 35 patients who underwent impaction allografting of the proximal femur were reviewed. Of Gruen zones that could be clearly visualized, 39.9% contained areas where cement was absent. Even when an adequate mantle was present, cement voids were commonly seen. These cement mantle deficiencies were confirmed in a series of cadaveric impaction allografting procedures. They appear to be a consequence, at least in part, of an inadequate differential between trial and actual component sizes. Additionally, 4 patients were identified with significant component migration secondary to radiographically visible cement mantle fractures within the first 6 months of surgery. It is concluded that the surgical technique requires modification to ensure a more consistent cement mantle and clinical result.
authors.affiliation: Department of Orthopaedics, Vancouver Hospital and Health Sciences Centre, British Columbia, Canada.
authors.forename: E L
authors.initials: EL
authors.lastname: Masterson
authors.forename: B A
authors.initials: BA
authors.lastname: Masri
authors.forename: C P
authors.initials: CP
authors.lastname: Duncan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016025:Bone Transplantation; D005260:Female; D005269:Femur / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D014184:Transplantation, Homologous