Evolution of Cementation Techniques and Bone Cements in Hip Arthroplasty

Niculescu, Marius; Solomon, Lucian B.; Viscopoleanu, George; Antoniac, Iulian Vasile

doi:10.1007/978-3-319-12460-5_42

Cited by 5 publications

(8 citation statements)

References 35 publications

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“…Modern femoral canal cementation techniques have evolved considerably from the rudimentary first-generation methods 9 . Modern techniques aim to improve the cement-bone interlock through bone preparation and cleansing.…”

Section: Application and Insertion Factorsmentioning

confidence: 99%

“…Modern techniques aim to improve the cement-bone interlock through bone preparation and cleansing. Preparation of the bone bed through rasping, high-pressure pulsatile saline lavage irrigation, use of a distal cement restrictor, cement pressurization, and insertion of the stem with a distal centralizer are considered standard 9,50 .…”

Section: Application and Insertion Factorsmentioning

confidence: 99%

“…Although some in vivo studies reported peak temperatures of greater than 56°C, the temperature at which collagen denatures, these peak temperatures typically exist for only short periods [9][10][11] . This fact, combined with the excellent outcomes of cemented protheses, can lead one to speculate that in vivo temperatures might not exceed the temperature threshold and time required for protein coagulation, at least not to a clinically important degree 9,12,13 .…”

Section: Cement Properties and Preparation Thermal Considerationsmentioning

confidence: 99%

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Femoral Stem Cementation in Primary Total Hip Arthroplasty

et al. 2022

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Femoral stem cementation has undergone considerable investigation since bone cement was first used in arthroplasty, leading to the evolution of modern femoral stem cementation techniques. » Although there is a worldwide trend toward the use of cementless components, cemented femoral stems have shown superiority in some studies and have clear indications in specific populations. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A863).

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Section: Application and Insertion Factorsmentioning

confidence: 99%

Section: Application and Insertion Factorsmentioning

confidence: 99%

Section: Cement Properties and Preparation Thermal Considerationsmentioning

confidence: 99%

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Femoral Stem Cementation in Primary Total Hip Arthroplasty

et al. 2022

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“…In TKA, standard techniques include employment of high-pressure pulsatile saline lavage irrigation as well as drilling holes into the sclerotic tibia, drying the bone and applying vacuum-mixed cement to both implant and bone [ 9 ]. Third-generation cementing techniques in THA involve aggressive rasping, using high-pressure pulsatile saline lavage irrigation, using a distal cement restrictor, applying vacuum-mixed cement using a retrograde technique into the femur via a cement gun, pressurizing the cement and inserting the stem with a distal centralizer [ 10 ]. Despite these efforts to ensure strong fixation of the transplant, aseptic loosening is the main reason for revision after cemented TKA and THA [ 5 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Pulsatile Lavage Systems with High Impact Pressure and High Flow Produce Cleaner Cancellous Bone Prior to Cementation in Cemented Arthroplasty

Knappe

Bitsch²,

Schonhoff

et al. 2021

JCM

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In cemented joint arthroplasty, state-of-the-art cementing techniques include high-pressure pulsatile saline lavage prior to cementation. Even with its outstanding importance in cementation, there are surprisingly few studies regarding the physical parameters that define pulsatile lavage systems. To investigate the parameters of impact pressure, flow rate, frequency and the cleaning effect in cancellous bone, we established a standardized laboratory model. Standardized fat-filled carbon foam specimens representing human cancellous bone were cleaned with three different high-pressure pulsatile lavage systems. Via CT scans before and after cleaning, the cleaning effect was evaluated. All systems showed a cleaning depth of at least 3.0 mm and therefore can be generally recommended to clean cancellous bone in cemented joint arthroplasty. When comparing the three lavage systems, the study showed significant differences regarding cleaning depths and volume, with one system being superior to its peer systems. Regarding the physical parameters, high impact pressure in combination with high flow rate and longer distance to the flushed object seems to be the best combination to improve the cleaning of cancellous bone and therefore increase the chances of a deeper cement penetration that is required in cemented joint arthroplasty. In summary, this study provides the first standardized comparison of different lavage systems and thus gives initial guidance on how to optimally prepare cancellous bone for cemented joint arthroplasty.

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“…In total hip arthroplasty third generation cementing technique is performed. This includes preparing bone bed properly by aggressive rasping, using high-pressure pulsatile saline lavage irrigation, using a distal cement restrictor, applying vacuum-mixed-cement in retrograde technique into the femur via cement gun, pressurizing the cement and inserting the stem with a distal centralizer [11]. Despite improved technique of cementing, aseptic loosening is still the main reason for revision after cemented total knee and hip arthroplasty [6,12,13].…”

Section: Introductionmentioning

confidence: 99%

Does Pressurized Carbon Dioxide Lavage Improve Bone Cleaning in Cemented Arthroplasty?

et al. 2021

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Cemented implant fixation in total joint arthroplasty has been proven to be safe and reliable with good long-term results. However, aseptic loosening is one of the main reasons for revision, potentially caused by poor cementation with low penetration depth in the cancellous bone. Aim of this prospective laboratory study was, to compare impact pressure and cleaning effects of pulsatile saline lavage to novel carbon dioxide lavage in a standardized carbon foam setup, to determine whether or not additional use of carbon dioxide lavage has any impact on cleaning volume or cleaning depth in cancellous bone. Carbon specimens simulating human cancellous bone were filled with industrial grease and then underwent a standardized cleaning procedure. Specimens underwent computed tomography pre- and post-cleaning. Regarding the impact pressure, isolated carbon dioxide lavage showed significant lower pressure compared to pulsatile saline lavage. Even though the combination of carbon dioxide lavage and pulsatile saline lavage had a positive cleaning effect compared to the isolated use of pulsatile saline lavage or carbon dioxide lavage, this was not significant in terms of cleaning volume or cleaning depth.

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Evolution of Cementation Techniques and Bone Cements in Hip Arthroplasty

Cited by 5 publications

References 35 publications

Femoral Stem Cementation in Primary Total Hip Arthroplasty

Femoral Stem Cementation in Primary Total Hip Arthroplasty

Pulsatile Lavage Systems with High Impact Pressure and High Flow Produce Cleaner Cancellous Bone Prior to Cementation in Cemented Arthroplasty

Does Pressurized Carbon Dioxide Lavage Improve Bone Cleaning in Cemented Arthroplasty?

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