Femoral cement pressurization in hip arthroplasty: a comparison of 3 systems

Cement pressurization is critical to achieving optimal results in cemented arthroplasty of the hip. An in vitro experiment using plastic femoral models (10 per group) was undertaken to measure the pressures developed by 3 cementing systems: the Howmedica Mark 1 (Stryker Howmedica, Limerick, Ireland) and DePuy Cemvac retrograde cementation systems (DePuy CMW, Blackpool, UK), and a novel antegrade system consisting of a 60-mL catheter-tipped syringe and a Miller proximal femoral seal (Zimmer Ltd, Swindon, UK). The mean pressure was higher for the syringe system (161.45 +/- 28.9 kPa) than the Mark 1 (103.51 +/- 22.0 kPa) or Cemvac (92.65 +/- 30.7 kPa) systems (P = .0001). In addition, fewer cement mantle defects were seen with the syringe system (1, interquartile range [IQR] 1-2) than the Mark 1 (3, IQR 2-4) or Cemvac (3, IQR 1-3) systems (P = .0256).