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.

Ultrasonic cement removal in cement-in-cement revision total hip arthroplasty

“…During cement-in-cement revision, a taper slip stem is typically used, loading the cement mantle in compression. 8,20 This study tests the samples in shear to replicate previous cement-in-cement studies, 14 which may limit its clinical relevance. As a result, however, this does provide evidence to compare directly with previous laboratory data, and raises an important consideration.…”