Bone cement penetration of the acetabulum in total hip replacement

The stem-cement interface experiences fretting wear in vivo due to low-amplitude oscillatory micromotion under physiological loading, as a consequence it is considered to play an important part in the overall wear of cemented total hip replacement. Despite its potential significance, in-vitro simulation to reproduce fretting wear has seldom been attempted and even then with only limited success. In the present study, fretting wear was successfully reproduced at the stem-cement interface through an in-vitro wear simulation, which was performed in part with reference to ISO 7206-4: 2002. The wear locations compared well with the results of retrieval studies. There was no evidence of bone cement transfer films on the stem surface and no fatigue cracks in the cement mantle. The cement surface was severely damaged in those areas in contact with the fretting zones on the stem surface, with retention of cement debris in the micropores. Furthermore, it was suggested that these micropores contributed to initiation and propagation of fretting wear. This study gave scope for further comparative study of the influence of stem geometry, stem surface finish, and bone cement brand on generation of fretting wear.

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Pressurization of Bone Cement under Standard, Flanged and Custom Acetabular Components for Total Hip Replacement

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1243/pime_proc_1993_207_264_02 ◽

1993 ◽

Vol 207 (1) ◽

pp. 19-23 ◽

Cited By ~ 7

Author(s):

D E Beverland ◽

W G Kernohan ◽

J R Nixon ◽

J F Orr ◽

P Watson

Keyword(s):

Bone Cement ◽

Total Hip Replacement ◽

Cancellous Bone ◽

Hip Replacement ◽

Initial Pressure ◽

Constant Force ◽

Total Hip ◽

Component Design ◽

Set Up ◽

Acetabular Components

Custom acetabular components are proposed to achieve uniform cement mantles, even in irregular acetabula presented at revision, in order to enhance fixation. One aim of developing custom components was to permit pressurization of bone cement by the components at insertion and maintain the pressure during polymerization. A model acetabulum was set up for the insertion of standard, flanged and custom components under constant force. Cement pressure was measured at the floor of the acetabulum by means of a piezoelectric diaphragm transducer. Polythene tubes were inserted in the model acetabular walls to estimate penetration of cement into cancellous bone. Insertion of the standard and flanged components caused cement pressures up to 106 kPa which decayed to less than 21 kPa as cement escaped at the rim and the components came into contact with the acetabulum. The custom component maintained a pressure of over 60 kPa during polymerization from an initial pressure of 105 kPa and examination of cement mantles on removal showed no evidence of contact. The custom component also showed enhanced penetration of cement, especially around the rim of the acetabulum. It is concluded that the custom component design achieves higher cement pressures and that better fixation will result.

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Respiratory complications of bone cement insertion during total hip replacement under spinal anaesthesia

European Journal of Anaesthesiology ◽

10.1097/00003643-199701000-00010 ◽

1997 ◽

Vol 14 (1) ◽

pp. 52-54 ◽

Cited By ~ 2

Author(s):

R. N. Lewis

Keyword(s):

Bone Cement ◽

Total Hip Replacement ◽

Spinal Anaesthesia ◽

Hip Replacement ◽

Respiratory Complications ◽

Total Hip

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Cement Burn of the Skin During Hip Replacement

Annals of The Royal College of Surgeons of England ◽

10.1308/003588407x168262 ◽

2007 ◽

Vol 89 (2) ◽

pp. 151-152 ◽

Cited By ~ 3

Author(s):

Ben Burston ◽

Piers Yates ◽

Gordon Bannister

Keyword(s):

Bone Cement ◽

Total Hip Replacement ◽

Hip Replacement ◽

Total Hip ◽

Partial Thickness ◽

Partial Thickness Burn

We present the first reported case of a partial thickness burn to the skin from discarded bone cement during a routine total hip replacement (THR). The patient required plastic surgical attention for 5 months before the skin was healed. We summarise the reported incidents of cement burns to various other structures and the circumstances in which these injuries can potentially occur.

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