Segmental femoral cement extraction at revision hip arthroplasty - a safe technique

Conventional methods of femoral cement extraction at revision hip arthroplasty may be associated with incomplete cement removal, excessive sacrifice of cancellous bone stock, inadvertent cortical perforation, or fracture. Segmental femoral cement extraction is a technique, first introduced in the early 1990s to optimise cement removal while minimising the potential complications of this procedure. It involves the instilling of fresh polymethylmethacrylate (PMMA) into the carefully prepared cement mantle after implant removal. Segments of new cement bound to the old mantle are then extracted. Since its initial description, few subsequent series have been published to validate or discredit this technique. We report on 25 consecutive femoral revisions employing this system. Complete cement removal was achieved in 88%. The integrity of the femoral cortex was preserved in all cases with no perforations or fractures.