- complications: - note that exothermic reaction (and ensuing heat) that occurs during cement hardening may injure soft tissue structures opposite of acetabulum (especially
when the acetabulum is thin); - component loosening:
- patients may or may not show symptoms from cemented cup loosening;
- radiographic demarcation of the bone cement interface on immediate postoperative x-rays is a strong risk factor for early component loosening;
- as noted by Garcia-Cimbrello et al 1997, 13 of 18 cups with a complete radiolucent line on initial radiographs migrated;
- as noted by Kavanaugh and Fitzgerald 1987, 70% of cemented acetabular revisions developed progressive radiolucencies;
- these authors noted a 10% failure rate at 2 years;
- references:
- The mechanism of loosening of cemented acetabular components in total hip arthroplasty. Analysis of specimens retrieved at autopsy.
- Progression of radiolucent lines adjacent to acetabular component and factors influencing migration after Charnley low friction THA.
E Garcia-Cimbrelo MD et al. JBJS Vol 79-A. No 9. Sep 1997. p 1373.
- Failure of the Mecring screw-ring acetabular component in total hip arthroplasty. A three to seven-year follow-up study.
- Loosening of the cemented hip prosthesis. The importance of heat injury.
- Early migration of acetabular components revised with cement. A roentgen stereophotogrammetric study.
Multiple revision for failed total hip arthroplasty not associated with infection. Kavanaugh, BK and Ritzgerald, RH. JBJS. Vol 69-A. 1987. p 1144-1149.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Clifford R. Wheeless, III, MD on Sunday, September 6, 2009 11:52 am