Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. A 12-year radiographic review

TLDR

The study evaluated whether improved femoral cementing techniques reduce loosening rates in patients 50 years or younger by reviewing 50 second‑generation cemented hip arthroplasties in 44 individuals. All stems were collared, rectangular with rounded corners, and cement was injected via a gun into a distally occluded canal; patients were followed clinically and radiographically for an average of 12 years with complete follow‑up. No femoral component required revision for aseptic loosening, and only one stem was definitively loose radiographically, whereas 11 patients had acetabular component revisions for symptomatic aseptic loosening and another 11 showed radiographic signs of acetabular loosening.

Abstract

To assess the effect of improved methods of femoral cementing on the loosening rates in young patients, we reviewed 50 'second-generation' cemented hip arthroplasties in 44 patients aged 50 years or less. The femoral stems were all collared and rectangular in cross-section with rounded corners. The cement was delivered by a gun into a medullary canal occluded distally with a cement plug. A clinical and radiographic review was undertaken at an average of 12 years (10 to 14.8) and no patient was lost to follow-up. No femoral component was revised for aseptic loosening, and only one stem was definitely loose by radiographic criteria. By contrast, 11 patients had undergone revision for symptomatic aseptic loosening of the acetabular component and 11 more had radiographic signs of acetabular loosening.