Updated: Jun 14, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
Published on: February 27, 2018
A Fottner1, S Utzschneider, F Mazoochian
1Orthopädische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, Campus Grosshadern, München. andreas.fottner@med.uni-muenchen.de
This article reviews modern cementing techniques used in hip arthroplasty, focusing on how these methods affect implant survival. The study highlights the importance of polished shafts, vacuum-mixed cements, medullary canal plugs, centralizing elements, and jet-lavages. Polished shafts showed slightly better outcomes than rough ones. Vacuum-mixed cements improved cement mantle quality. Medullary canal plugs reduced cement debris in the bloodstream. Centralizing elements helped maintain proper alignment. Jet-lavages improved canal preparation and cement flow. The authors suggest that these refinements may improve implant longevity and should be considered in clinical practice.
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Area of Science:
Background:
Cemented anchorage remains a standard in hip arthroplasty, particularly for elderly patients. Prior research has shown that cementing techniques significantly affect implant survival. Established methods include vacuum-mixed cements and medullary canal plugs. However, uncertainties remain about optimal surface finishes for cemented shafts. This gap motivated recent studies to refine cementing protocols. No prior work had resolved the exact role of shaft surface texture. The field lacks consensus on whether polished or rough surfaces yield better outcomes. That uncertainty drove the current investigation into cementing techniques.
Purpose Of The Study:
This study aimed to evaluate modern cementing techniques for hip prostheses. The specific problem addressed is the long-term survival of implants in elderly patients. The motivation stems from the need to refine cementing protocols for better outcomes. The focus is on comparing polished and rough shaft surfaces. The study sought to determine which surface finish improves implant longevity. The goal was to identify optimal components of cementing techniques. The authors aimed to synthesize evidence from recent clinical studies. Their aim was to guide clinical practice in cemented hip arthroplasty.
Polished shafts showed slightly better outcomes in implant survival compared to rough surfaces.
Vacuum-mixed cements improve cement mantle quality, reducing voids and enhancing implant survival.
Medullary canal plugs reduce cement debris in the bloodstream, improving patient safety.
Centralizing elements help maintain proper alignment and improve cement distribution in the femoral canal.
Main Methods:
The study reviewed recent clinical data on cemented hip prostheses. It analyzed the role of vacuum-mixed cements and medullary canal plugs. The approach included evaluating centralizing elements and jet-lavages. The focus was on comparing polished and rough shaft surfaces. Data were synthesized from multiple clinical studies. The review considered how surface finish affects cement mantle quality. The authors examined implant survival rates in elderly patients. Their method involved comparing outcomes across different surface types.
Main Results:
Polished shafts showed slightly better outcomes than rough surfaces. The difference in implant survival was small but statistically significant. Vacuum-mixed cements improved cement mantle quality in most studies. Medullary canal plugs reduced cement debris in the bloodstream. Centralizing elements improved cement distribution in the femoral canal. Jet-lavages enhanced canal preparation and cement flow. The cement mantle thickness was more uniform with polished shafts. These findings suggest refinements in cementing techniques improve outcomes.
Conclusions:
The authors propose that polished shafts may offer slight advantages over rough ones. They suggest that vacuum-mixed cements improve implant survival. Medullary canal plugs and centralizing elements are key components. Jet-lavages may enhance cement flow and distribution. The study supports refining cementing techniques for better outcomes. The findings suggest that small procedural changes may improve longevity. The authors propose that these techniques should be adopted in clinical practice. Their conclusion is based on synthesized evidence from recent clinical studies.
Jet-lavages enhance canal preparation and improve cement flow, leading to better cement mantle formation.
The authors propose that polished shafts may offer slight advantages in implant longevity compared to rough surfaces.