Conventional methods of femoral cement extraction at revision hip arthroplasty may be associated with incomplete cement removal, excessive sacrifice of cancellous bone stock, inadvertent cortical perforation, or fracture. Segmental femoral cement extraction is a technique, first introduced in the early 1990s to optimise cement removal while minimising the potential complications of this procedure. It involves the instilling of fresh polymethylmethacrylate (PMMA) into the carefully prepared cement mantle after implant removal. Segments of new cement bound to the old mantle are then extracted. Since its initial description, few subsequent series have been published to validate or discredit this technique. We report on 25 consecutive femoral revisions employing this system. Complete cement removal was achieved in 88%. The integrity of the femoral cortex was preserved in all cases with no perforations or fractures.
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http://dx.doi.org/10.1007/s00590-002-0037-2 | DOI Listing |
J Orthop Surg Res
January 2025
Department of Epidemiology, School of Health, Mashhad University of Medical Science, Mashhad, Iran.
Background: In order to increase the stability of tibial component in total knee arthroplasty (TKA), intramedullary stem extensions (SE) have been developed. The aim of this systematic review and meta-analysis is to address the critical knowledge gap on post-operative outcomes and complications rate comparison between tibial component with SE compared to the tibial component standard configuration (SC) in primary cemented TKA.
Methods: We conducted a comprehensive search of online databases, including Pubmed, Embase, ISI Web of science, Cochrane Library, and Scopus, using the following MeSH terms, (total knee arthroplasty) OR (TKA) OR (total knee replacement) AND (Tibial stem) OR (stem extension) OR (long stem).
Introduction: For total hip arthroplasty (THA) to be successful, surgeons need to make several decisions ranging from implant choice to impaction force. It is unclear, however, whether and how bone quality affects surgeon's decision-making and how surgeons evaluate bone quality.
Objectives: This inductive/deductive qualitative hybrid study aims to explore the impact of bone quality on the decision-making of surgeons performing elective primary THA.
Expert Rev Med Devices
January 2025
Department of Orthopaedic Surgery, Kansai Medical University, Hirakata, Osaka, Japan.
Introduction: There is a worldwide trend toward 'revisiting' cemented total hip arthroplasty (THA). In Japan, however, cemented THAs accounts for 11%, and the percentage of cemented hemiarthroplasty is estimated to be less than 10%. This review was designed to reconsider the option of cemented THA and to encourage policy changes in Japan to support the best possible care for patients.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Dental Biomaterials Science, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea.
This study aimed to evaluate the effects of nanoparticulate CaCO (NPCC) on the biological properties of calcium silicate-based cements (CSCs), including their cytotoxicity, in vitro osteogenic activity, and interactions with rat femur tissue. The average size of NPCC was 90.3±26.
View Article and Find Full Text PDFBone Joint J
January 2025
Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Kadoorie Centre, University of Oxford, Oxford, UK.
Aims: There is compelling evidence for the use of cemented hip hemiarthroplasty for displaced intracapsular hip fractures; however, the risks of cement are well reported and in rare cases may be associated with haemodynamic collapse. It is therefore important to improve our understanding of haemodynamic instability, intraoperative monitoring, and strategies to reduce the risk to patients.
Methods: We measured arterial blood pressure using the LiDCO Continuous Non-invasive Arterial Pressure (CNAP) finger cuff during surgery in patients enrolled in the WHiTE 5 trial randomized to cemented or modern uncemented hip hemiarthroplasty at a single recruiting site.
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