Cemented hip arthroplasty: techniques used in primary and revision surgery

Abstract

For over 50 years, total hip replacement has revolutionized quality of life for patients. Registry data supports the use of cemented implants for their longevity, and their ability to recreate patients' anatomy in even the most extreme cases is unique. Over decades of use, cementing techniques have been studied and modified to improve implant survivorship and there is no doubt that a sound understanding of the philosophy and practice of modern cementing techniques is key to high level performance. This article describes the techniques for cementing the acetabulum and femur in primary hip replacement, along with those in revision, both using bone graft and cement, and when cementing into an existing cement mantle. Included is also a description of cement use in the context of infection, and the significance of periprosthetic fractures around cemented implants. The aim of this article is to explain not only how to use cement, but also why. This article will demonstrate cement's versatility as a mode of implant fixation in both the primary and revision setting.