title: Cementing technique in femoral resurfacing.
abstract: BACKGROUND
  The cementing technique is one of the various speculated factors that might contribute to the failures of resurfacing arthroplasty of the hip. The influence of bony preparation by jet lavage or lavage only in combination with different cementing techniques and cements of different viscosity in a study on fresh human femoral heads has not been evaluated so far.
  
  
  METHODS
  Sixty fresh human femoral heads were prepared for resurfacing following manufacturers' instructions and divided into 12 groups. The different groups received either syringe lavage or jet lavage and either a low-, medium- or high-viscosity cement with either packing or quarter filling of the implant with recess of the femoral stem in each case. Application of the implant was standardized. After polymerization, the femoral heads were cut into quarters and polished. Cement penetration was assessed using a square millimeter grid under optical zoom.
  
  
  RESULTS
  Manual packing with high viscosity cement is a reproducible method in resurfacing arthroplasty. Syringe lavage and jet lavage mainly showed comparable cement penetration patterns when applied same cementing techniques. The penetration depth ranged from a mean of 0.6 to 3.2 mm with 0.4 being the lowest and 4.0 being the deepest. The mantle thickness ranged from 0.8 to 2.4 mm with statistically significant thicker mantles with filling, compared to packing.
  
  
  CONCLUSIONS
  Our results showed distinct less penetration depth than previously reported and that just medium viscosity cement reached reliable results in the supposed range of penetration depth and cement mantle thickness. Jet lavage should be recommended for the low-viscosity cement but avoided in combination with a cement filling technique of lower viscosity cements. Filling of the implant caused the greatest penetration depth and a higher number of incomplete seatings and should therefore be avoided.
authors.affiliation: University of Regensburg, Regensburg, Germany. drjbeckmann@gmx.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Beckmann
authors.forename: Claudia
authors.initials: C
authors.lastname: Goldapp
authors.forename: Kerstin
authors.initials: K
authors.lastname: Ringleff
authors.forename: Jens
authors.initials: J
authors.lastname: Schaumburger
authors.forename: Joachim
authors.initials: J
authors.lastname: Grifka
authors.forename: Lars
authors.initials: L
authors.lastname: Perlick
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements; D002484:Cementation / Q000379:methods*; D005260:Female; D005270:Femur Head / Q000601:surgery*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric
chemical_list: D001843:Bone Cements