The polished tri-tapered stem for cement-in-cement revision hip arthroplasty, a reliable and reproducible technique?

Abstract

The object of this study was to determine the short to medium term outcome of cementing a highly polished tapered implant into the old cement mantle once damaged cement is removed at the time of revision hip surgery. A consecutive series of 36 patients underwent c-stem cement-in-cement revision hip arthroplasty between June 2000 and April 2006. The primary outcome measure was the validated shortened Western Ontario and McMaster Universities (WOMAC) score, secondary outcomes were the Orthowave company patient satisfaction survey, radiological analysis, and general complications. The follow-up period was between 12 and 84 months (average 48.86 months). The mean post op WOMAC score at latest follow-up was 10.89 (0 to 29). Two patients died with their hip in situ. Two patients had radiological signs of prosthesis loosening on follow-up. Complications included: one sacral plexus palsy which had a partial recovery and one intra-operative periprosthetic fracture. One patient underwent cup revision for recurrent dislocation. Cement within cement revision hip arthroplasty using a highly polished tapered stem in the short to medium term provides satisfactory functional outcomes and is associated with a low complication rate and good survivorship.

Stem compatibility for cement-in-cement femoral revision: an in vitro study

“…Clinically this technique has been validated in a series of 136 Exeter stem cement-in-cement revisions with five- to 15-year follow-up, in which no femoral re-revisions for aseptic loosening were necessary (10). Other encouraging results have been reported by centres using a variety of femoral components (5, 12–13–14–15).…”

Treatment of Failures Related to Articulation Material in THA. A Comprehensive Algorithm of Surgical Options and Open Questions

“…Again the Explant technique for the socket and the extended trochanteric osteotomy (ETO) or a femoral window for the stem removal can be necessary. Cemented stems can be recemented in a stable mantle (40, 41) with the cement within cement technique in older patients.…”