PMID: 11915452Mar 28, 2002Paper

Current state of cement fixation in THR

Acta orthopaedica Belgica
E W Morscher, D Wirz

Abstract

The author surveys important landmarks in the development of total hip arthroplasty, with an accent on implant fixation using acrylic cement. He explains why he personally opted for hybrid prostheses, combining a cemented stem and a cementless socket, in patients over sixty years. Excellent cementless, sockets have been available for a long time; on the femoral side, the first steps were difficult, but several cementless, stems were subsequently developed, which provided excellent long term results. This historical evolution resulted in a very uneven use of cemented versus cementless stems from one country to another in Europe. Cemented implants have enjoyed a renewed popularity over the past few years as a result of several factors, including economical factors. The author discusses the conditions for optimal fixation of a cemented stem; these conditions are not always met satisfactorily, as a number of surgeons obviously stick to a crude cementing technique. The author describes the role of the stem geometry and surface finish, as well as the possible influence of a centralizer; he explains why, based on a correct analysis of the available data, discredit has been unduly cast on cemented stems made of titanium alloy. He insis...Continue Reading

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