Thin cement mantle and osteolysis with a precoated stem

Area of Science:

• Orthopedic surgery
• Biomaterials science
• Radiology

Background:

• Total hip arthroplasty (THA) is a common procedure for hip joint diseases.
• Cementing techniques are crucial for the longevity of THA implants.
• Harris precoat hip prosthesis with second-generation cementing technique was evaluated.

Purpose of the Study:

• To investigate the radiographic and clinical outcomes of THA using the Harris precoat hip prosthesis.
• To determine the relationship between cement mantle characteristics and the incidence of osteolysis and aseptic loosening.

Main Methods:

• Retrospective review of 55 hips (52 patients) who underwent THA.
• Radiographic assessment of cement mantle quality (thickness and defects) using Mulroy et al. criteria.
• Clinical follow-up for an average of 8 years.

Main Results:

• Aseptic loosening occurred in 5.5% of femoral components and 3 sockets were loosened acetabularly.
• Femoral osteolysis was observed in 12.7% of hips.
• 49% of hips had cement mantles <1mm or with defects, and 26% of these showed osteolysis.

Conclusions:

• A thin cement mantle (<1mm) or defects in the cement mantle are significant risk factors for developing osteolysis in THA.
• Cement mantle integrity is critical for preventing bone loss and ensuring the long-term success of cemented hip prostheses.