[Cemented total hip arthroplasty in Germany - update 2010].

Area of Science:

• Orthopaedic surgery
• Biomaterials science
• Surgical techniques

Background:

• National surveys in 1998 and 2005 revealed low adoption rates of modern cementing techniques in total hip arthroplasty (THA) in Germany.
• A 2010 survey aimed to assess the current prevalence and popularity of these advanced cementing methods.

Purpose of the Study:

• To evaluate the current adoption of modern cementing techniques in total hip arthroplasty (THA) in Germany.
• To determine the trend in the popularity of these techniques compared to previous surveys.

Main Methods:

• A detailed questionnaire on cement and bone preparation, cementing techniques, and implant types was distributed to 492 German orthopaedic and trauma hospitals.
• A response rate of 51.8% yielded 255 usable questionnaires for statistical analysis.

Main Results:

• Palacos R+G remained the most used bone cement (52.2%), with vacuum mixing systems gaining popularity (85.2%).
• Surgeons increasingly preserved cancellous bone (78.6%) and used pulsatile lavage (77.8%) for femur preparation. Retrograde cement application via gun (85.8%) and cement restrictors (>98%) were common.
• Despite improvements, sustained cement pressurisation (72.7%) and specific acetabular techniques (e.g., multiple keyholes, 18.1%) showed lower adherence. High THA volumes correlated with better cementing techniques.

Conclusions:

• Cemented total hip arthroplasty (THA) techniques in Germany have significantly improved since 2005.
• Emphasis on continued surgeon education and training is vital for optimizing cementing techniques and ensuring long-term implant durability.