title: Cement applicator use for hip resurfacing arthroplasty.
abstract: We compared the manufacturer recommended cementing technique for a femoral hip resurfacing implant (BHR, S&N) to a newly designed cement applicator on 20 porous carbon foam specimens. Substantial design changes and improvements of the cement applicator were necessary: The diameter and number of the cement escaping holes at the top of the applicator were optimized for medium viscosity cement. It was necessary to add four separate air inlet holes with large diameters. The inner shape of the applicator had to be adapted to the BHR design with a circular extending chamfer in the proximal region, a parallel inner wall and a second chamfer distally. The interface temperatures showed no risk for heat necrosis using both techniques. The cement penetration depth was more uniform and significantly reduced for the applicator cementing technique (4.34 ± 1.42 mm, 6.42 ± 0.43 mm, p = 0.001). The cement-applicator showed no cement defects compared to a large defect length (0.0 ± 0.0 mm, 10.36 ± 1.10 mm, p < 0.001) with the manufacturer recommended cementing technique. The cement applicator technique appears to be effective for a homogenous cement distribution without cement defects and safe with a lower risk of polar over-penetration.
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jaeger
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
authors.forename: Johannes S
authors.initials: JS
authors.lastname: Rieger
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
authors.forename: Beate
authors.initials: B
authors.lastname: Obermeyer
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
authors.forename: Matthias C
authors.initials: MC
authors.lastname: Klotz
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany.
authors.forename: J Philippe
authors.initials: JP
authors.lastname: Kretzer
authors.affiliation: Laboratory of Biomechanics and Implant Research, Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany. Electronic address: Rudi.Bitsch@med.uni-heidelberg.de.
authors.forename: Rudi G
authors.initials: RG
authors.lastname: Bitsch
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D004867:Equipment Design; D005269:Femur / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008954:Models, Biological; D011312:Pressure; D013696:Temperature; D014783:Viscosity
chemical_list: D001843:Bone Cements
keywords: Cement applicator; Cement defect; Cementing technique; Hip resurfacing arthroplasty; Pressure; Temperature