Comparative prospective trial of 3 intramedullary plugs in cemented total hip arthroplasty

We assessed the occlusion and stability of 3 intramedullary plugs used to restrict the femoral canal before primary cemented arthroplasty. In a prospective, randomized trial the Biosem (SEM, Montrouge, France), Cemlock (Sulzer Orthopaedic Ltd, Baar, Switzerland), and Thackray (DePuy International Ltd, Leeds, England) plug were compared in 93 hip joints replaced by the Stanmore hip prosthesis. We considered a range of 1 cm on the postoperative radiograph a measuring fault. According to the definition, 43% (40/93) were not stable. The percentages of deficient plugs were: Biosem 78% (25/32), Cemlock 32% (9/28), and Thackray 18% (6/33). The differences found between the Biosem and Cemlock and between the Biosem and Thackray were significant. No significant effect was seen regarding the sizes of the plugs used. Comparison of the smaller sizes of the prosthesis versus the larger sizes showed a significant effect on the stability of the plugs.