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Current attitudes to cementing techniques in British hip surgery
A Hashemi-Nejad1, N C Birch, N J Goddard
1Orthopaedic Department, Royal Free Hospital NHS Trust, London.
Annals of the Royal College of Surgeons of England
|November 1, 1994
Summary
Many British surgeons do not use modern cementing techniques for hip replacements, potentially increasing the risk of early implant revision. This study surveyed techniques used by orthopedic surgeons in the UK.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
- Medical Device Technology
Background:
- Aseptic loosening is a primary cause of failure in hip joint replacements.
- Improved cementing techniques can significantly enhance the long-term survival of hip implants.
Purpose of the Study:
- To evaluate the adoption and utilization of modern cementing techniques among British orthopedic surgeons.
- To identify current practices in cement preparation, bone preparation, and cementing application during total hip arthroplasty.
Main Methods:
- A detailed questionnaire was distributed to Fellows of The British Orthopaedic Association (BOA).
- Data collected from 668 respondents performing 43,680 hip arthroplasties annually.
- Survey covered cement types, bone preparation, surgical techniques, and prostheses used.
Main Results:
- Only 25% of surveyed surgeons employ 'modern' cementing techniques for total hip arthroplasty.
- Significant variation exists in bone preparation (e.g., cancellous bone removal, pulse lavage) and cement application (e.g., pressurization).
- 46% of surgeons use Palacos with gentamicin, and 48% of implanted hips are Charnley type.
Conclusions:
- The low adoption rate of modern cementing techniques suggests a potential for increased rates of early revision surgeries.
- Standardization and education on optimal cementing protocols are crucial for improving long-term hip arthroplasty outcomes.