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Varying success seen with manufacturer recommendations for cementing hip resurfacings
German researchers of this study tested manufacturer recommendations for cementing hip resurfacing implants and found varying degrees of success.
"To the best of our knowledge our work was the first study that separately analyzed the effect of hip resurfacing component designs and cementing technique recommendations of the manufacturers using a highly standardized and bone validated model," Rudi G. Bitsch, MD, and colleagues wrote in their study. "The design of the femoral hip resurfacing components influenced all measured variables significantly."
They added, “The implant sensitivity to changes of cementing technique differed strongly with peak temperatures above 50°C and a risk for thermal bone necrosis. We found a safe upper limit of cement penetration of 4.2 mm for all tested components and cementing techniques.”
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The Articular Surface Replacement (DePuy; Warsaw, Ind.) showed low cement pressures of 58 kPA and low interface temperatures of 33.3°C, according to the study abstract. When testing the Birmingham Hip Resurfacing implant (Smith & Nephew; London, United Kingdom), Bitsch and colleagues found large cement defects of 10.4 mm.
Among the implants, Conserve Plus (Wright Medical Technology; Arlington, Tenn.) had the lowest cement penetration depths, at 2.9 mm, according to the abstract. Durom (Zimmer, Inc.; Warsaw, Ind.) had the widest spread of temperature gauge data, at 42.8°C, while ReCap (Biomet, Inc.; Warsaw, Ind.) had a cement mantle thickness of 4.3 mm, indicating the highest risk for incomplete seating.
Disclosure: Bitsch has no relevant financial disclosures.