Cementing acetabular sockets into metal-backed acetabular components and antiprotrusio cages: a technical tip

Cementing a polyethylene socket or acetabular liner into a well-fixed metal-backed acetabular shell has become a useful procedure in selected complex primary and revision hip arthroplasties. Polyethylene sockets are frequently cemented into antiprotrusio cages as well. Frequently, these metallic devices are fixed to host bone with acetabular screws. Unfortunately, when polyethylene sockets are cemented into such devices, the cement fills the recess within the screw head and makes subsequent screw removal extremely difficult should the device need to be removed or revised. The author describes a technique of filling the screw heads with bone wax and gel foam before cementation. This keeps the recess within the screw head relatively patent and allows easier removal of the screw in the future should it become necessary.