2008 Otto Aufranc Award: Component Design and Technique Affect Cement Penetration in Hip Resurfacing

Beaulé, Paul E.; Matar, Wadih Y.; Poitras, Philippe; Smit, Kevin; May, Olivier

doi:10.1007/s11999-008-0541-8

Cited by 33 publications

(24 citation statements)

References 45 publications

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“…Experimental studies [16,18,25] have demonstrated the importance of proper cementation, particularly against the background of the different cementing philosophies being applied to the different implant designs [11]. However, clinical retrieval analyses of present-generation HRAs, demonstrating the cementation technique and associated structural changes beneath the femoral component, are rare [13].…”

Section: Discussionmentioning

confidence: 99%

“…However, different cementing strategies apply to different implant designs [11]. Whereas some prosthetic designs allow a cement mantle of about 1 mm by providing a greater clearance between implant and bone, such as the Durom (Zimmer Orthopaedics, Warsaw, IN, USA), ASR (DePuy Orthopaedics, Warsaw, IN, USA) and ReCap (Biomet Orthopaedics, Warsaw, IN, USA), other designs such as the BHR (Smith & Nephew PLC, London, UK) or Cormet (Corin Medical, Cirencester, UK) have a tighter femoral component fit and allow minimal or no cement mantle [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

“…Several experimental studies recommend cement penetration into the bone of about 3-5 mm [15,16] to achieve optimal fixation and prevent harmful polymerisation temperatures [17], to achieve successful long-term fixation. Several studies [11,18,19] emphasise the importance of proper cementation. However, investigations into the clinical realisation of the recommended cementation technique for HRA, including quantitative cement data, are rare [13].…”

Section: Introductionmentioning

confidence: 99%

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Cementation and interface analysis of early failure cases after hip-resurfacing arthroplasty

Krause

Breer

Hahn

et al. 2012

International Orthopaedics (SICOT)

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Purpose The use of inappropriate cementation techniques has been suggested as an adverse factor for the long-term survival of hip-resurfacing arthroplasty. Inadequate initial fixation, thermal osteonecrosis and interface biological reactions are possible causes of failure. We analysed morphological changes associated with the cementation technique in a large collection of retrieved femoral components. Methods One hundred and fifty femoral components (mean time to failure of 8.3 months±11.0) obtained at revision surgery were analysed morphometrically and histopathologically. Cement mantle and penetration were quantified in six different regions of interest. Histopathological analysis of the bone-cement interface was performed on undecalcified processed bone tissue. Results The vast majority of the cases differed substantially from laboratory-based cement-penetration depth recommendations. Fifty-nine cases had a fibrous membrane at the cement-bone interface. This membrane was significantly thicker in cases with osteonecrosis compared to cases viable bone. Conclusions Our results demonstrate that most failures were cemented inappropriately. We suggest that poor cementation was an important adverse factor; however, the cause of the failures was obviously multifactorial. The thickness of the fibrous membrane at the cement-bone interface differed significantly between cases with osteonecrosis and specimens with viable bone tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cementation and interface analysis of early failure cases after hip-resurfacing arthroplasty

Krause

Breer

Hahn

et al. 2012

International Orthopaedics (SICOT)

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“…There have been several investigations into the utilization of cement for hip resurfacing [1][2][3][4][5][6][7][8]. A number of factors can affect the cement-bone interface, including lavage, haemostasis, bone density, cement mixing, cement viscosity, timing, temperature, cementing technique and component design.…”

Section: Introductionmentioning

confidence: 99%

The influence of cementing technique in hip resurfacing arthroplasty on the initial stability of the femoral component

Bitsch

Jäger

Lürssen

et al. 2011

International Orthopaedics (SICOT)

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Purpose In clinical and retrieval analyses, over-penetration of cement, incomplete seating of the prosthesis with a resultant polar cement mass, or both, have been associated with early femoral failures of resurfacing arthroplasties. We used human bone specimens to experimentally compare the initial stability of different cementing techniques. Methods Twenty-six pairs of fresh frozen femora were prepared for resurfacing using original instruments (DePuy ASR). ASR femoral resurfacing prostheses were implanted using two different cementing techniques: (1) component filling and (2) cement applicator. Real-time measurements of pressure and temperature during implantation, analyses of cement penetration and micro motions under torque application were performed. Results Applicator use reduced significantly the cement penetration depth (9.2 mm vs 5.3 mm with the applicator, p=0.001), polar mantle (8.1 mm vs 2.6 mm, p=0.008), cement defects (3.7 mm vs 0.1 mm, p = 0.008) and interface temperatures (40.3°C vs 33.1°C, p<0.001 ). Initial rotational stability showed statistically significant less extreme values with the cement applicator technique (range 3.4-51.7 m°/Nm, 11.0-29.7 m°/Nm, p=0.024). Conclusions The cement applicator technique significantly reduces cement defects, incomplete seating, overpenetration and interface temperatures with a more consistent initial stability of the ASR femoral resurfacing prostheses.

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“…The cementbone interface is therefore a geometric interlock between two porous materials. The depth of interdigitation varies between 1 and 5 mm (Beaulé et al, 2009;Mann et al, 1997), depending on cement viscosity and other factors. This interface is usually modeled with bonded contacts in the literature Taylor, 2006), as it is assumed to be rigid.…”

Section: The Cement-bone Interfacementioning

confidence: 99%

Influence of the stem fixation scenario on load transfer in a hip resurfacing arthroplasty with a biomimetic stem

Caouette

Bureau

Vendittoli

et al. 2015

Journal of the Mechanical Behavior of Biomedical Materials

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2008 Otto Aufranc Award: Component Design and Technique Affect Cement Penetration in Hip Resurfacing

Cited by 33 publications

References 45 publications

Cementation and interface analysis of early failure cases after hip-resurfacing arthroplasty

Cementation and interface analysis of early failure cases after hip-resurfacing arthroplasty

The influence of cementing technique in hip resurfacing arthroplasty on the initial stability of the femoral component

Influence of the stem fixation scenario on load transfer in a hip resurfacing arthroplasty with a biomimetic stem

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