CURRENT ATTITUDES TO CEMENTING TECHNIQUES IN BRITISH HIP-SURGERY

Aseptic loosening is the major problem in hip joint replacement. Impro ved cementing techniques have been shown to improve the long-term surv ival of implants significantly. To assess the use of modern cementing techniques in British surgeons, a detailed questionnaire was sent to a ll Fellows of The British Orthopaedic Association (BOA) regarding ceme nt preparation, bone preparation, cementing technique and prostheses u sed in total hip arthroplasty. Excluding retired fellows, surgeons who use no cement, and those who had filled in forms inadequately, 668 re sponded, who between them performed 43 680 hip arthroplasties per year . In this survey, 21 different types of hip prostheses were implanted by the surgeons; 48% of hips implanted were Charnley type. Of the surg eons, 46% used Palacos with gentamicin as their cement for both the fe mur and acetabulum. For the femur, 44% of surgeons remove all cancello us bone, 40% use pulse lavage, 59% use a brush to clear debris, 94% dr y the femur, 97% plug the femur, 76% use a cement gun and 70% pressuri se the cement. For the acetabulum, 88% of surgeons retain the subchond ral bone, 40% use pulse lavage, 100% dry the acetabulum, 22% use hypot ensive anaesthesia and 58% pressurise the cement. Overall only 25% of surgeons (26% of hips implanted) use 'modern' cementing techniques. Th is has implications for the number of arthroplasties that may require early revision.