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Evolution of Cementation Techniques and Bone Cements in Hip Arthroplasty

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Handbook of Bioceramics and Biocomposites

Abstract

Cementing techniques have evolved considerably since cemented hip arthroplasty was first introduced by Sir John Charnley in the 1970s. Much has been learned about the properties of bone cement, and with this understanding, techniques associated with its use have evolved. Substantial improvements have been made during its evolution from the first to third generation of cementing techniques. The main developments have been in the areas of bone preparation, cement preparation, and cement delivery. First-generation cementing techniques were quite rudimentary, and long-term results for cemented implants were not impressive by today’s standards. These techniques have evolved significantly over time, in line with the increased knowledge regarding cement properties and behavior and the impact of bone preparation on the bone-cement interface. Since the beginnings of cemented arthroplasty, many important factors which can affect the quality of fixation have been improved. The mean survival of a cemented hip implant in the early years was approximately 10 years. With the evolution of cementing techniques, this value has increased significantly with some hip implants now surviving over 25 years. The survivorship is greatly influenced by the quality of the fixation, which is dependent on a solid bone-cement interface. This interface is created by interdigitation of cement particles in the cancellous bone of the femur. The bone bed must be cleaned of debris and blood in order for the cement to penetrate the cancellous bone as deeply as possible. Penetration is dependent on pressurization of the cement in the femoral canal and acetabulum and is achieved by the use of specialized tools. The cementing techniques and materials used in modern orthopedic practice and possible future developments will be discussed. In order to give more practical information related to the cementation in orthopedic surgery, authors will present the surgical technique and operative steps of a cemented hip arthroplasty, well illustrated with images during surgical intervention. Also, different concept recently introduced in the field of cemented total hip arthroplasty will be presented.

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Author information

Authors and Affiliations

  1. Department of Orthopaedics and Trauma I, Colentina Clinical Hospital, Bucharest, Romania

    Marius Niculescu

  2. Faculty of Medicine, Titu Maiorescu University, Bucharest, Romania

    Marius Niculescu

  3. Royal Adelaide Hospital, Department of Orthopaedics and Trauma, Centre for Orthopaedic and Trauma Research and Discipline of Orthopaedics and Trauma, The University of Adelaide, Adelaide, SA, 5000, Australia

    Bogdan Lucian Solomon

  4. Department of Orthopaedic Surgery, “Foisor” Orthopaedic Hospital, Bucharest, Romania

    George Viscopoleanu

  5. University Politehnica of Bucharest, Bucharest, Romania

    Iulian Vasile Antoniac

Authors
  1. Marius Niculescu
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  2. Bogdan Lucian Solomon
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  3. George Viscopoleanu
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  4. Iulian Vasile Antoniac
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Correspondence to Marius Niculescu .

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Editors and Affiliations

  1. University Politehnica of Bucharest, Bucharest, Romania

    Iulian Vasile Antoniac

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© 2016 Her Majesty the Queen in Right of Australia

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Niculescu, M., Solomon, B.L., Viscopoleanu, G., Antoniac, I.V. (2016). Evolution of Cementation Techniques and Bone Cements in Hip Arthroplasty. In: Antoniac, I. (eds) Handbook of Bioceramics and Biocomposites. Springer, Cham. https://doi.org/10.1007/978-3-319-12460-5_42

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