In-cement technique for revision hip arthroplasty

Quinlan, John; O’Shea, Kieran; Doyle, Fintan; Brady, O.

doi:10.1302/0301-620x.88b6.17037

Cited by 64 publications

(49 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2a, b), acetabular failures in which the surgery is easier if the femoral component is taken out, conversion from a cemented hemiarthroplasty to a THA and recurrent dislocation (Fig. 3a, b) [17,18,20,22].…”

Section: Discussionmentioning

confidence: 99%

“…Quinlan et al [22] have recently published a series of patients using the femoral CWC technique, including cases with prosthetic infection, reporting no clinical or radiographic failures. No cases of infection were included in our series, due to the fact that we consider retaining cement in septic cases could be related to persistent infection [2].…”

Section: Discussionmentioning

confidence: 99%

“…From a biomechanical viewpoint, this technique was validated by studies reported by Greenwald et al [12]. Although the method is about to turn 20 years old, the results of the cement within cement (CWC) technique have been described in the literature by few authors [17,18,20,22].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Femoral cement within cement technique in carefully selected aseptic revision arthroplasties

Marcos

Buttaro

Piccaluga

2008

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

The aim of this study was to evaluate the clinical and radiological results in a group of patients who underwent aseptic revision hip arthroplasty using the cement within cement (CWC) technique. Between 1999 and 2005, 37 aseptic revision hip operations were performed. There were 30 women and five men, with an average age of 68 years. The reasons for revision were femoral stem fracture, cup failure, acetabular protrusion after hemiarthroplasty and recurrent dislocation. At an average follow-up of 46 months, none of the patients required further femoral revision. The average post-operative Merle D'Aubigne score was 16.6 points (p<0.05). No evidence of radiological stem failure was observed and no femoral component was considered to be at risk for loosening. In this series of patients, the CWC technique provided consistent with high functional outcomes. This valid and effective alternative should be considered in carefully selected aseptic cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Femoral cement within cement technique in carefully selected aseptic revision arthroplasties

Marcos

Buttaro

Piccaluga

2008

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…First described by Greenwald 7 several studies now exist investigating its success. [8][9][10] In a large study from Exeter, Duncan et al 11 followed 136 revision hips for a mean of 8 years and monitored the patients clinically and radiographically using the Barrack cement mantle grading system, 12 and had a 100% survival rate for femoral loosening and stem subsidence. Goto et al 13 from Japan also had good survivorship in their series of 44 revision hips using this technique, although they reported a 20% femoral fracture rate.…”

Section: Discussionmentioning

confidence: 99%

A valuable technique for femoral stem revision in total hip replacement: The in-cement revision – A case series and technical note

McDougall

Calligeros

et al. 2016

Journal of Orthopaedics

View full text Add to dashboard Cite

A valuable technique for femoral stem revision in total hip replacement: The in-cement revision -A case series and technical note IntroductionRevision of a cemented femoral stem can be a challenging procedure. Removing the cement mantle requires time and patience with a risk of further bone damage and possible fracture.1-4 Retention of the old cement mantle and insertion of a smaller or shorter stem -the cement-in-cement revisiondescribed for taper stems -provides a good alternative if the cement mantle is stable, but is limited if a smaller size or offset stem is already in situ. We present a newly described technique, the ''In-cement'' revision -the introduction of a stem, the same size as the original implant, into the previous cement mantle, without additional cement or downsizing. This has not been previously described or investigated in the literature. We present the technique and a series of 23 cases. In-cement revision requires an intact and stable cement mantle in the correct version. The benefits include improved view of the acetabulum, time efficiency, the ability to use the same size stem and utilisation of the previous distal centralised spacer plug to facilitate subsidence. TechniqueAfter either general or spinal anaesthetic, the patient is positioned laterally. An incision is made through the previous scar and the hip is exposed through a posterior approach. After appropriate dissection and debridement, the hip is dislocated, the head tapped off and the cemented, polished, tapered stem is removed (Fig. 1).There are three primary keys in the technique:1. Inspection of the cement mantle for stability and version (Fig. 2).Inspect the cement mantle for cracks and coverage. Forceps or a pituitary rongeur are used to attempt to mobilise the cement and therefore determine if it is stable. Version is assessed and is deemed either appropriate or not appropriate. If the version of the previous stem is not appropriate or the cement mantle is not stable, an in-cement revision should not be pursued. 2. Protection of the cement mantle (Fig. 3).Place a moist swab in the canal to prevent debris from the acetabular revision dropping into the cement mantle.The acetabulum is then exposed and revised as appropriate. 3. Reinsertion of the same size stem without a centraliser (Fig. 4).No centraliser is used to facilitate subsidence. Tap in the stem until it re-engages with the taper. Double check the length of the Revision of a cemented femoral stem can be a challenging procedure. We present a series of cases utilising the ''In-cement'' revision, whereby the same size stem is introduced into the original cement mantle, without additional cementing. It requires a stable cement mantle in the correct version.We describe the technique and present a review of 23 revision total hip replacements performed over a 5 year period. At average follow-up of 67 months (12-128 months), the overall survivorship was 91.3% with no patient requiring re-revision for stem loosening or mechanical failure. Two patients required rerevision for...

show abstract

“…Bonding of the new cement to the old mantle is good and allows implantation of a smaller sized cemented stem. Specific cemented revision stems have recently come to market for this purpose and the technique has good reported medium-term results [28][29][30]. When the old cement mantle has failed and requires removal, cemented revision, without supplemental graft, has produced disappointing long-term results: the shear strength of the new cement-bone interface is up to 80% weaker than in primary THR [31].…”

Section: Hip Reconstructionmentioning

confidence: 99%