CEMENT-WITHIN-CEMENT REVISION HIP-ARTHROPLASTY

We reviewed 19 revision hip arthroplasties in which the new femoral co mponent had been recemented into the old, Intact cement mantle. The me an time from the first operation to revision was 64 months and the ave rage follow-up was 59 months. There were 7 excellent, 11 good, and one fair result. No femoral component had been revised for loosening and all the stems appeared radiographically stable. Complications included intraoperative perforation of the femur on two occasions and one disl ocation. The use of the cement-within-cement technique requires that t he old cement surface be dry and roughened to increase the surface are a and that the cement be injected in the liquid phase to prevent lamin ation. The indications for this technique include a broken stem with a n intact distal cement mantle, the removal of a femoral component for revision of a loose cup to improve exposure and/or increase offset, re current dislocation secondary to component malposition, and debonding of the femoral component within an intact cement mantle.