title: An in-vitro investigation into the cement pressurization achieved during insertion of four different femoral stems.
abstract: Adequate cement pressurization during stem insertion improves the interdigitation of cement into bone. This increases the strength of the cement-bone interface, thus contributing to the reduction of the incidence of aseptic loosening, the commonest cause of revision surgery. This in-vitro study compared the cement pressurization achieved during insertion of four different stems of equivalent sizes: the Elite Plus (DePuy, UK), C-Stem (DePuy, UK), Exeter (Stryker, USA), and CPS-Plus (Plus Orthopedics, Switzerland). The maximum pressures attained at the time of stem insertion were recorded at proximal, mid and distal stem levels. The Elite Plus generated significantly higher distal pressures than the other stems. The CPS-Plus generated significantly greater proximal cement pressures than the Elite Plus, C-Stem, and Exeter prostheses. The triple taper of the C-Stem increased the cement pressurization medial to the stem. The stem shape and the presence or absence of a proximal stem centralizer affect cement pressurization. The presence of a proximal stem centralizer, a large stem volume, and a lateral-medial taper are all factors associated with increased cement pressurization during stem insertion.
authors.affiliation: Department of Orthopaedic Surgery, University of Bristol, Bristol, UK.
authors.forename: C
authors.initials: C
authors.lastname: Gozzard
authors.forename: S
authors.initials: S
authors.lastname: Gheduzzi
authors.forename: A W
authors.initials: AW
authors.lastname: Miles
authors.forename: I D
authors.initials: ID
authors.lastname: Learmonth
mesh_terms: D000268:Adhesiveness; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D001843:Bone Cements; D002484:Cementation / Q000379:methods*; D019544:Equipment Failure Analysis; D006622:Hip Prosthesis; D006801:Humans; D019904:Polymethyl Methacrylate; D011312:Pressure; D017755:Prosthesis Fitting / Q000379:methods*; D019919:Prosthesis Implantation / Q000379:methods*
chemical_list: D001843:Bone Cements; D019904:Polymethyl Methacrylate