Revision Total Hip Arthroplasty Using the Cement-in-Cement Technique

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Biomaterials Engineering

Background:

• The cement-in-cement technique is a valuable option for revision total hip arthroplasty (THA).
• It facilitates acetabular exposure and allows modification of femoral components (version, offset, length).
• Common indications include aseptic loosening, periprosthetic fracture, instability, and implant fracture.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of revision THA utilizing the cement-in-cement technique.
• To assess the efficacy and complication rates associated with this specific revision strategy.

Main Methods:

• Retrospective analysis of 63 revision THAs performed between 1971 and 2013.
• Utilized Omnifit or Exeter stems with the cement-in-cement technique.
• Clinical follow-up averaged 5.5 years, assessing Harris Hip Score and complication rates.

Main Results:

• A statistically significant improvement in Harris Hip Score (18.5 points, P<.001) was observed post-revision.
• The overall failure rate was 21%, with 18% requiring further revision THA.
• Aseptic removal of the femoral component was rare (2%); other femoral implants showed no signs of migration or cement issues.

Conclusions:

• Revision THA using the cement-in-cement technique can restore patient function effectively.
• However, this technique is associated with a considerable rate of complications.
• Further research may be needed to optimize patient selection and minimize adverse outcomes.