Improved acetabular pressurization gives better cement penetration

The influence of initial pressurization and cup introduction time on the depth of cement penetration in an acetabular model

“…Cup introduction was therefore not a major factor in further increasing the depth of cement penetration. These findings are in agreement with the results of Flivik et al (2004), who showed that although the highest peak pressure was achieved during cup introduction, this did not affect the depth of cement penetration any further. Thus, the cement took the path of least resistance instead and escaped out of the acetabulum around the advancing cup where there was no counter pressure.…”

Migration of the acetabular component: Effect of cement pressurization and significance of early radiolucency

“…By fluoroscopy, the X-ray tube was angled in the cranio-caudal direction to obtain an image tangential to the steel wire in the base of the acetabular component. Using a multimodality workstation (Fuji HIC654), the three individual anchorage holes in the os ilium, with their cement protrusions, could be separated (Flivik et al 2004). …”

“…There have been no studies published comparing the outcome of conventional fingerpacking with pressurization of the cement. In order to optimize cement pressurization, we have previously suggested-and successfully tested-a sequential cementation technique with pressurization of individual anchorage holes before filling the entire acetabular cavity with cement (Flivik et al 2004).…”

Prosthesis survival after total hip arthroplasty—does surgical approach matter? Analysis of 19,304 Charnley and 6,002 Exeter primary total hip arthroplasties reported to the Norwegian Arthroplasty Register

“…To our knowledge this has not been reported previously. Several explanations may be relevant, including the possibility that trochanteric osteotomy in a supine position might give (1) a better overview of the acetabulum and easier orientation of the pelvis, making the correct orientation of the cup easier; (2) less residual blood in the acetabulum in the supine position, providing a dryer acetabulum during the cementing process (Bannister and Miles 1988); (3) improved position and approach to push and stabilize the cup, and consequently better cementing technique to achieve a stronger cement-bone interface (Stark et al 1982, Flivik et al 2004); (4) less micromovements during the cementing process (Schmalzried et al 1992). As the lateral approach without a trochanteric osteotomy and performed in a side position was introduced in many hospitals during the first time period, the learning process may have contributed to inferior results with this approach.…”