title: Clinical and radiological evaluation of revision hip arthroplasty using the cement-in-cement technique.
abstract: We reviewed 44 consecutive revision hip replacements in 38 patients performed using the cement-in-cement technique. All were performed for acetabular loosening in the presence of a well-fixed femoral component. The mean follow-up was 5.1 years (2 to 10.1). Radiological analysis at final follow-up indicated no loosening of the femoral component, except for one case with a continuous radiolucent line in all zones and peri-prosthetic fracture which required further revision. Peri-operative complications included nine proximal femoral fractures (20.4%) and perforation of the proximal femur in one hip. In five hips wiring or fixation with a braided suture was undertaken but no additional augmentation was required. There was an improvement in the mean Japanese Orthopaedic Association score from 55.5 (28 to 81) pre-operatively to 77.8 (40 to 95) at final follow-up (p < 0.001). Revision using a cement-in-cement technique allows increased exposure for acetabular revision and is effective in the medium term. Further follow-up is required to assess the long-term results in the light of in vitro studies which have questioned the quality of the cement-in-cement bond.
authors.affiliation: Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan. k.g.bau@kuhp.kyoto-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Goto
authors.forename: K
authors.initials: K
authors.lastname: Kawanabe
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.forename: T
authors.initials: T
authors.lastname: Morimoto
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000379:methods* / Q000592:standards; D001843:Bone Cements / Q000592:standards*; D002484:Cementation / Q000379:methods* / Q000592:standards; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D013997:Time Factors
chemical_list: D001843:Bone Cements