title: Should the cement mantle around the femoral component be thick or thin?
abstract: We have compared the survival and radiological outcome at ten years after total hip replacement using two techniques for preparing the femoral canal. The same prosthesis was used throughout and all operations were performed by the same surgical team. In technique 1 the canal was over-reamed by 2 mm and in technique 2 it was reamed to the same size as the prosthesis. Technique 1 was performed on 92 patients and technique 2 on 97 patients. The survival at ten years was 97.2% (90.6 to 99.2) for technique 1 and 98.8% (92.9 to 99.8) for technique 2. Vertical migration was greater in technique 1 (1.8 mm versus 1.0 mm at five years; p = 0.36). There were significantly more lytic lesions and radiolucent lines at five years (p = 0.0061) with technique 1. We conclude that technique 2 is not worse and may produce better long-term results than current teaching suggests.
authors.affiliation: Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Skinner
authors.forename: S
authors.initials: S
authors.lastname: Todo
authors.forename: M
authors.initials: M
authors.lastname: Taylor
authors.forename: J S
authors.initials: JS
authors.lastname: Wang
authors.forename: V
authors.initials: V
authors.lastname: Pinskerova
authors.forename: G
authors.initials: G
authors.lastname: Scott
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000592:standards*; D001843:Bone Cements; D002484:Cementation / Q000379:methods*; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis / Q000592:standards*; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D016019:Survival Analysis
chemical_list: D001843:Bone Cements