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Cement pressurisation during hip replacement

A W McCaskie1, M R Barnes, E Lin

  • 1The Glenfield Hospital NHS Trust, Leicester, England, UK.

The Journal of Bone and Joint Surgery. British Volume
|May 1, 1997
PubMed
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Cementing techniques for hip replacements were compared. Using a cement gun resulted in higher pressures but less physiological disturbance than manual finger-packing, indicating a potentially safer method.

Area of Science:

  • Orthopedic surgery
  • Biomaterials science
  • Surgical techniques

Background:

  • Modern cementing techniques for femoral stems aim to enhance bone-cement interlock using high pressure and low viscosity.
  • Concerns exist regarding potential fat and marrow embolization, leading to adverse physiological events like hypotension and impaired gas exchange.
  • The safety of high-pressure cementing methods has been questioned, necessitating comparative studies.

Purpose of the Study:

  • To compare intramedullary pressures and physiological changes between finger-packing and cement gun techniques during total hip replacement.
  • To evaluate the consistency and pressure generation of different cementing methods in a laboratory setting.

Main Methods:

  • Intramedullary pressures were measured during cementing in 31 total hip replacement surgeries.

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  • Physiological changes were monitored in 19 of these patients.
  • Laboratory models were used to further analyze pressure dynamics with both finger-packing and cement gun techniques.

    • Main Results:

    • Cement gun technique generated higher intramedullary pressures compared to finger-packing in clinical cases.
    • Despite higher pressures, the cement gun technique resulted in less physiological disturbance than finger-packing.
    • Laboratory studies indicated more consistent results with the cement gun.
    • Both methods generated peak pressures during prosthesis stem insertion.

    Conclusions:

    • While cement gun use leads to higher pressures, it may be associated with less physiological disturbance than manual finger-packing during hip arthroplasty.
    • Further research is warranted to optimize cementing techniques for improved patient safety and implant fixation.