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Cement-Bone Interface in Revision Arthroplasty

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Bone-Implant Interface in Orthopedic Surgery

Abstract

For primary total hip arthroplasty (THA), several fixation options are available. Cemented, cementless, or hybrid principles have been applied, and their advantages, disadvantages, and their long-term effectiveness have been well described in the literature. A recent study reported the superior survival of cemented to uncemented THA which was related to better performance of the cemented cups. On the other hand, uncemented stems have proved to perform better than cemented stems; the risk of revision was found to be similar in both implants.

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References

  1. Hailer NP, Garellick G, Kärrholm J. Uncemented and cemented primary total hip arthroplasty in the Swedish Hip Arthroplasty Register. Acta Orthop. 2010;81(1):34–41.

    Article  PubMed  Google Scholar 

  2. Amstutz HC, Ma SM, Jinnah RH, et al. Revision of aseptic loose total hip arthroplasties. Clin Orthop. 1982;170:21–33.

    PubMed  Google Scholar 

  3. Callaghan JJ, Salvati EA, Pellici PM, et al. Results of revision for mechanical failure after cemented total hip replacement 1979 to 1982: a two to five year follow up. J Bone Joint Surg Am. 1885;67A:1074–85.

    Google Scholar 

  4. Franzen H, Mjoberg B, Onnerfalt R. Early migration of acetabular components revised with cement: a roentgen stereophotogrammetric study. Clin Orthop. 1993;287:131–4.

    PubMed  Google Scholar 

  5. Garcia-Cimberelo E, Munuera L, Diez-Vazquez V. Long term results of aseptic cemented Charnley revisions. J Arthroplasty. 1995;10:121–31.

    Article  Google Scholar 

  6. Kavanagh BF, Fitzerald Jr RH. Multiple revisions for failed total hip arthroplasty not associated with infection. J Bone Joint Surg Am. 1987;69A:1144–9.

    Google Scholar 

  7. Kavanagh BF, Ilstrup DM, Fitzerald Jr RH. Revision total hip arthroplasty. J Bone Joint Surg Am. 1985;67A:517–26.

    Google Scholar 

  8. Raut VV, Wroblewski BM. Revision of the acetabular component of a total hip arthroplasty with cement in young patients without rheumatoid arthritis. J Bone Joint Surg Am. 1996;78A:1853–6.

    Google Scholar 

  9. Snorrason F, Karrholm J. Early loosening of revision hip arthroplasty: a roentgen stereophotogrammetric analysis. J Arthroplasty. 1990;5:217–29.

    Article  PubMed  CAS  Google Scholar 

  10. Lieberman JR, Moeckel BH, Evans BG, Salvati EA, Ranawat CS. Cement-within-cement revision hip arthroplasty. J Bone Joint Surg Br. 1993;75B:869–71.

    Google Scholar 

  11. Rosenstein A, MacDonald W, Iliadis A, McLardy-Smith P. Revision of cemented fixation and cement – bone interface strength. Proc Inst Mech Eng H. 1992;206:47–9.

    PubMed  CAS  Google Scholar 

  12. Duncan WW, Hubble MJW, Howell JR, Whitehouse SL, Timperley AJ, Gie GA. Revision of the cemented femoral stem using a cement-in-cement technique: a five- to 15-year review. J Bone Joint Surg Br. 2009;91B:577–82.

    Google Scholar 

  13. Briant-Evans TW, Veeramootoo D, Tsiridis E, Hubble MJW. Cement-in-cement stem revision for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty. A 3-year follow-up of 23 cases. Acta Orthop Scand. 2009;80(5):548–52.

    Article  Google Scholar 

  14. Wroblewski BM. 15-21-year results of the Charnley low-friction arthroplasty. Clin Orthop. 1986;211:30–5.

    PubMed  Google Scholar 

  15. Bradford MS, Paprosky WG. Acetabular defect classification: a detailed radiographic approach. Semin Arthroplasty. 1995;6:76–85.

    PubMed  CAS  Google Scholar 

  16. Nelson CL. Cemented cup revisions. Am J Orthop. 2002;31(8):479–80.

    PubMed  Google Scholar 

  17. Toossi N, Adeli B, Timperley AJ, Haddad FS, Maltenfort M, Parvizi J. Acetabular components in total hip arthroplasty: is there evidence that cementless fixation is better? J Bone Joint Surg Am. 2013;95A:168–74.

    Article  Google Scholar 

  18. Morshed S, Bozic KJ, Ries MD, Malchau H, Colford Jr JM. Comparison of cemented and uncemented fixation in total hip replacement: a meta-analysis. Acta Orthop Scand. 2007;78(3):315–26.

    Article  Google Scholar 

  19. DiFazio FA. The current status of acetabular fixation in total hip replacement. Orthop Rev. 1992;21(9):1067–71.

    PubMed  CAS  Google Scholar 

  20. Slooff TJ, Schimmel JW, Buma P. Cemented fixation with bone grafts. Orthop Clin North Am. 1993;24(4):667–77.

    PubMed  CAS  Google Scholar 

  21. Gross AE. Restoration of acetabular bone loss 2005. J Arthroplasty. 2006;21(S1):117–20.

    Article  PubMed  Google Scholar 

  22. Gross AE. Revision arthroplasty of the acetabulum with restoration of bone stock. Clin Orthop. 1999;369:198–207.

    Article  PubMed  Google Scholar 

  23. Haverkamp D, De Man FH, Slegt R, Besselaar PP, Marti RK. Cemented hip revision surgery in severe acetabular defects using a semirigid acetabular reinforcement ring–a 5- to 25-year follow-up study. J Arthroplasty. 2009;24(2):246–55.

    Article  PubMed  Google Scholar 

  24. Oakes DA, Cabanela ME. Impaction bone grafting for revision hip arthroplasty: biology and clinical applications. JAAOS. 2006;14(11):620–8.

    Google Scholar 

  25. Buttaro MA, Comba F, Pusso R, Piccaluga F. Acetabular revision with metal mesh, impaction bone grafting, and a cemented cup. Clin Orthop. 2008;466:2482–90.

    Article  PubMed  Google Scholar 

  26. Schreurs BW, Bolder SB, Gardeniers JW, Verdonschot N, Slooff TJ, Veth RP. Acetabular revision with impacted morsellised cancellous bone grafting and a cemented cup. A 15- to 20-year follow-up. J Bone Joint Surg Br. 2004;86B:492–7.

    Google Scholar 

  27. Schreurs BW, Luttjeboer J, Thien TM, de Waal Malefijt MC, Buma P, Veth RP, Slooff TJ. Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis. A concise follow-up, at eight to nineteen years, of a previous report. J Bone Joint Surg Am. 2009;91A:646–51.

    Article  Google Scholar 

  28. Kummer FJ, Adams MC, Dicesare PE. Revision of polyethylene acetabular liners with a cemented polyethylene cup: a laboratory study. J Arthroplasty. 2002;17(8):1055–7.

    Article  PubMed  Google Scholar 

  29. Padgett DE, Kull L, Rosenberg A, Sumner DR, Galante JO. Revision of the acetabular component without cement after total hip arthroplasty. J Bone Joint Surg Am. 1993;75A:663–73.

    Google Scholar 

  30. Harris WH. Reconstruction at a high hip centre in acetabular revision surgery using a cementless acetabular component. Orthopaedics. 1998;21:991–2.

    CAS  Google Scholar 

  31. Pulido L, Rachala SR, Cabanela ME. Cementless acetabular revision: past, present, and future. Revision total hip arthroplasty: the acetabular side using cementless components. Int Orthop. 2011;35:289–98.

    Article  PubMed  Google Scholar 

  32. Katz RP, Callaghan JJ, Sullivan PM, Johnston RC. Long-term results of revision total hip arthroplasty with improved cementing technique. J Bone Joint Surg Br. 1997;79B:322–6.

    Article  Google Scholar 

  33. Lie SA, Havelin LI, Furnes ON, Engesaeter LB, Vollset SE. Failure rates for 4762 revision total hip arthroplasties in the Norwegian Arthroplasty Register. J Bone Joint Surg Br. 2004;86B:504–9.

    Google Scholar 

  34. Marti RK, Schuller HM, Besselaar PP, et al. Results of revision of hip arthroplasty with cement: a five to fourteen year follow up study. J Bone Joint Surg Am. 1990;72A:346–54.

    Google Scholar 

  35. Dunbar MJ, Blackley HR, Bourne RB. Osteolysis of the femur: principles of management. Instr Course Lect. 2001;50:197–209.

    PubMed  CAS  Google Scholar 

  36. Pellici PM, Salvati EA, Robinson HJ. Mechanical failure in total hip replacement requiring reoperation. J Bone Joint Surg Am. 1979;61A:28–32.

    Google Scholar 

  37. Holt G, Hook S, Hubble M. Revision total hip arthroplasty: the femoral side using cemented implants. Int Orthop. 2011;35(2):267–73.

    Article  PubMed  Google Scholar 

  38. Nelson CL. Cemented femoral revision: technique and outcome. Am J Orthop. 2002;31(4):187–9.

    PubMed  Google Scholar 

  39. Raut VV, Siney PD, Wroblewski BM. Revision for aseptic stem loosening using the cemented Charnley prosthesis. J Bone Joint Surg Br. 1995;77B:23–7.

    Google Scholar 

  40. Weber K, Callaghan J, Goetz D, et al. Revision of a failed cemented total hip prosthesis with insertion of an acetabular component with cement and a femoral component with cement. A five to eight year follow up study. J Bone Joint Surg Am. 1996;78A:982–94.

    Google Scholar 

  41. Mulroy WF, Harris WH. Revision total hip arthroplasty with use of so called second generation cementing techniques for aseptic loosening of the femoral component. A fifteen year average follow up study. J Bone Joint Surg Am. 1996;78A:325–30.

    Google Scholar 

  42. McLaughlin JR, Harris WH. Revision of the femoral component of a total hip arthroplasty with the calcar replacement femoral component. Results after a mean of 10.8 years postoperatively. J Bone Joint Surg Am. 1996;78A:331–9.

    Google Scholar 

  43. Hultmark PP, Karrholm J, Stromberg C, et al. Cemented first time revisions of the femoral component. J Arthroplasty. 2000;15:551–61.

    Article  PubMed  CAS  Google Scholar 

  44. Harris WH, Crothers O, Oh J. Total hip replacement and femoral head bone grafting for severe acetabular deficiency in adults. J Bone Joint Surg Am. 1977;59A:752–63.

    Google Scholar 

  45. Hirst P, Esser M, Murphy JC, et al. Bone grafting for protrusio acetabuli during total hip replacement. J Bone Joint Surg Br. 1987;69B:229–36.

    Google Scholar 

  46. Mulroy RD, Harris WH. Failure of acetabular autogenous grafts in total hip arthroplasty. J Bone Joint Surg Am. 1990;72A:1536–43.

    Google Scholar 

  47. Roffman M, Silbermann M, Mendes D. Incorporation of bone graft covered with methyl-methacrylate onto the acetabular wall. Acta Orthop Scand. 1983;54:580–6.

    Article  PubMed  CAS  Google Scholar 

  48. Schimmel JW, Buma P, Versleyen D, et al. Acetabular reconstruction with impacted morselized cancellous bone grafts in cemented revision hip arthroplasty: a histological and biomechanical study on the goat. J Arthroplasty. 1998;13:438–48.

    Article  PubMed  CAS  Google Scholar 

  49. Schreurs BW, Buma P, Huiskes R, et al. A technique for using impacted trabecular allografts in revision surgery with cemented stems. Acta Orthop Scand. 1994;65:267–75.

    Article  PubMed  CAS  Google Scholar 

  50. Schreurs BW, Huiskes R, Buma P, et al. Biomechanical and histological evaluation of a hydroxyapatite-coated titanium femoral stem fixed with an intramedullary morselized bone grafting technique: an animal experiment on goats. Biomaterials. 1996;17:1177–86.

    Article  PubMed  CAS  Google Scholar 

  51. Buma P, Schreurs BW, Verdonschot N. Skeletal tissue engineering: from in vitro studies to large animal models. Biomaterials. 2004;25:1487–95.

    Article  PubMed  CAS  Google Scholar 

  52. van der Donk S, Weernink T, Buma P, et al. Rinsing allografts improves bone and tissue ingrowth. Clin Orthop. 2003;408:302–10.

    Article  PubMed  Google Scholar 

  53. Griffon DJ, Dunlop DG, Howie CR, Pratt JN, Gilchrist TJ, Smith N. An ovine model to evaluate the biologic properties of impacted morselized bone graft substitutes. J Biomed Mater Res. 2001;56(3):444–51.

    Article  PubMed  CAS  Google Scholar 

  54. de Stroet MA, Gardeniers JW, Verdonschot N, Rijnen WH, Slooff TJ, Schreurs BW. Femoral component revision with use of impaction bone-grafting and a cemented polished stem: a concise follow-up, at fifteen to twenty years, of a previous report. J Bone Joint Surg Am. 2012;94A:1731–4.

    Google Scholar 

  55. Iwase T, Otsuka H, Katayama N, Fujita H. Impaction bone grafting for femoral revision hip arthroplasty with Exeter Universal stem in Japan. Arch Orthop Trauma Surg. 2012;132(10):1487–94.

    Article  PubMed  Google Scholar 

  56. Patil N, Hwang K, Goodman SB. Cancellous impaction bone grafting of acetabular defects in complex primary and revision total hip arthroplasty. Orthopedics. 2012;35(3):306–12.

    Google Scholar 

  57. Busch VJ, Gardeniers JW, Verdonschot N, Slooff TJ, Schreurs BW. Acetabular reconstruction with impaction bone-grafting and a cemented cup in patients younger than fifty years old: a concise follow-up, at twenty to twenty-eight years, of a previous report. J Bone Joint Surg Am. 2011;93A:367–71.

    Google Scholar 

  58. Ornstein E, Linder L, Ranstam J, Lewold S, Eisler T, Torper M. Femoral impaction bone grafting with the Exeter stem – the Swedish experience: survivorship analysis of 1305 revisions performed between 1989 and 2002. J Bone Joint Surg Br. 2009;91B:441–6.

    Google Scholar 

  59. Cross M, Bostrom M. Cement mantle retention: filling the hole. Orthopedics. 2009;32(9).

    Google Scholar 

  60. Leonidou A, Pagkalos J, Luscombe J. Cement-in-cement acetabular revision with a constrained tripolar component. Orthopedics. 2012;35(2):e255–8.

    PubMed  Google Scholar 

  61. Mandziak DG, Howie DW, Neale SD, McGee MA. Cement-within-cement stem exchange using the collarless polished double-taper stem. J Arthroplasty. 2007;22(7):1000–6.

    Article  PubMed  Google Scholar 

  62. Greenwald AS, Narten NC, Wilde AH. Points in the technique of recementing in the revision of an implant arthroplasty. J Bone Joint Surg Br. 1978;60B:107–10.

    Google Scholar 

  63. Weinrauch P, Bell C, Wilson L, Goss B, Lutton C, Crawford R. Shear properties of bilaminar polymethylmethacrylate cement mantles in revision hip joint arthroplasty. J Arthroplasty. 2007;22:394–403.

    Article  PubMed  Google Scholar 

  64. Li PL, Ingle PJ, Dowell JK. Cement-within-cement revision hip arthroplasty; should it be done? A biomechanical study. J Bone Joint Surg Br. 1996;78B:809–11.

    Google Scholar 

  65. Dang K, Pelletier MH, Walsh WR. Factors affecting flexural strength in cement within cement revisions. J Arthroplasty. 2011;26(8):1540–8.

    Article  PubMed  Google Scholar 

  66. Brogan K, Charity J, Sheeraz A, Whitehouse SL, Timperley AJ, Howell JR, Hubble MJ. Revision total hip replacement using the cement-in-cement technique for the acetabular component: technique and results for 60 hips. J Bone Joint Surg Br. 2012;94B:1482–6.

    Google Scholar 

  67. Lieberman JR. Cemented femoral revision, lest we forget. J Arthroplasty. 2005;20:72–4.

    Article  PubMed  Google Scholar 

  68. Richards CJ, Duncan CP, Crawford RW. Cement-in-cement femoral revision for the treatment of highly selected vancouver B2 periprosthetic fractures. J Arthroplasty. 2011;26(2):335–7.

    Article  PubMed  Google Scholar 

  69. Keeling P, Prendergast PJ, Lennon AB, Kenny PJ. Cement-in-cement revision hip arthroplasty: an analysis of clinical and biomechanical literature. Arch Orthop Trauma Surg. 2008;128(10):1193–9.

    Article  PubMed  CAS  Google Scholar 

  70. McCallum JD, Hozack WJ. Recementing a femoral component into a stable cement mantle using ultrasonic tools. Clin Orthop. 1995;319:232.

    PubMed  Google Scholar 

  71. Beckmann J, Luring C, Springorum R, Kock FX, Grifka J, Tingart M. Fixation of revision TKA: a review of the literature. Knee Surg Sports Traumatol Arthrosc. 2011;19:872–9.

    Article  PubMed  CAS  Google Scholar 

  72. Bozic KJ, Kurtz SM, Lau E, Ong K, Chiu V, Vail TP, Rubash HE, Berry DJ. The epidemiology of revision total knee arthroplasty in the United States. Clin Orthop. 2010;468:45–51.

    Article  PubMed  Google Scholar 

  73. Ferhing TK, Odum S, Olekson C, Griffin WL, Mason JB, McCoy TH. Stem fixation in revision total knee arthroplasty: a comparative analysis. Clin Orthop. 2003;416:217–24.

    Article  Google Scholar 

  74. Al W, Trousdale RT, Rand JA, Hanssen AD. Cemented long-stem revision total knee arthroplasty. J Arthroplasty. 2003;18:592–9.

    Article  Google Scholar 

  75. Haas SB, Insall JN, Montgomery 3rd W, Windsor RE. Revision total knee arthroplasty with the use of modular components with stems inserted without cement. J Bone Joint Surg Am. 1995;77A:1700–7.

    Google Scholar 

  76. Mabry TM, Hanssen AD. The role of stems and augments for bone loss in revision knee arthroplasty. J Arthroplasty. 2007;22:56–60.

    Article  PubMed  Google Scholar 

  77. Peters CL, Erickson JA, Gilliland JM. Clinical and radiographic results of 184 consecutive revision total knee arthroplasties placed with modular cementless stems. J Arthroplasty. 2009;24:48–53.

    Article  PubMed  Google Scholar 

  78. Wood GC, Naudie DD, MacDonald SJ, McCalden RW, Bourne RB. Results of press fit stems in revision knee arthroplasty. Clin Orthop. 2009;467:810–7.

    Article  PubMed  Google Scholar 

  79. Marby TM, Vessely MB, Schleck CD, Harmsen WS, Berry DJ. Revision total knee arthroplasty with modular cemented stems: long term follow up. J Arthroplasty. 2007;22:100–5.

    Google Scholar 

  80. Whiteside LA. Cementless fixation in revision total knee arthroplasty. Clin Orthop. 2006;446:140–8.

    Article  PubMed  Google Scholar 

  81. Jazwari LM, Bai B, Kummer FJ, Hiebert R, Stuchin SA. The effect of stem modularity and mode of fixation on tibial component stability in revision total knee arthroplasty. J Arthroplasty. 2009;16:759–67.

    Google Scholar 

  82. Skwara A, Figied J, Knott T, Paletta JR, Fuchs-Winkelmann S, Tibesku CO. Primary stability of tibial components in TKA: in vitro comparison of two cementing techniques. Knee Surg Sports Traumatol Arthrosc. 2009;17:1199–205.

    Article  PubMed  Google Scholar 

  83. Completo A, Fonseca F, Simoes JA. Strain shielding in proximal tibia of stemmed knee prosthesis: experimental study. J Biomech. 2008;41:560–6.

    Article  PubMed  CAS  Google Scholar 

  84. Peters CL, Graig MA, Mohr RA, Bachus KN. Tibial component fixation with cement: full-versus surface cementation technique. Clin Orthop. 2003;409:158–68.

    Article  PubMed  Google Scholar 

  85. Completo A, Simoes JA, Fonseca F. Revision total knee arthroplasty: the influence of femoral stems in load shearing and stability. Knee. 2009;16:275–9.

    Article  PubMed  CAS  Google Scholar 

  86. Kim YH, Kim JS. Revision total knee arthroplasty with use of a constrained condylar knee prosthesis. J Bone Joint Surg Am. 2009;91A:1440–7.

    Article  Google Scholar 

  87. Bottner F, Laskin R, Windsor RE, Haas SB. Hybrid component fixation in revision total knee arthroplasty. Clin Orthop. 2006;446:127–31.

    Article  PubMed  Google Scholar 

  88. Peters CL, Erickson J, Kloepper RG, Mohr RA. Revision total knee arthroplasty with modular components inserted with metaphyseal cement and stems without cement. J Arthroplasty. 2005;20:302–8.

    Article  PubMed  Google Scholar 

  89. Shannon BD, Klassen JF, Rand JA, Berry DJ, Trousdale RT. Revision total knee arthroplasty with cemented components and uncemented intramedullary stems. J Arthroplasty. 2003;18:27–32.

    Article  PubMed  Google Scholar 

  90. Gofton WT, Tsigaras H, Butler RA, Patterson JJ, Barrack RL, Rorabeck CH. Revision total knee arthroplasty: fixation with modular stems. Clin Orthop. 2002;404:158–68.

    Article  PubMed  Google Scholar 

  91. Murray PB, Rand JA, Hanssen AD. Cemented long stem revision total knee arthroplasty. Clin Orthop. 1994;309:116–23.

    PubMed  Google Scholar 

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Karachalios, T., Makridis, K.G. (2014). Cement-Bone Interface in Revision Arthroplasty. In: Karachalios, T. (eds) Bone-Implant Interface in Orthopedic Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-5409-9_12

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