Use of a polyglycolide lactide cement plug restrictor in total hip arthroplasty

Citation
Ajm. Yee et al., Use of a polyglycolide lactide cement plug restrictor in total hip arthroplasty, CLIN ORTHOP, (364), 1999, pp. 254-266
Citations number
29
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Journal title
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
ISSN journal
0009921X → ACNP
Issue
364
Year of publication
1999
Pages
254 - 266
Database
ISI
SICI code
0009-921X(199907):364<254:UOAPLC>2.0.ZU;2-5
Abstract
The use of a polyglycolide lactide cement plug restrictor in cemented femor al fixation during total hip arthroplasty was evaluated. Femoral cement pre ssurization was evaluated in vitro in a cadaveric model and the host respon se to polymer degradation was evaluated in vivo in a canine total hip arthr oplasty model. Sixteen embalmed anatomic specimen femurs were prepared for cement femoral fixation, The intramedullary canal was plugged with either a n ultrahigh molecular weight polyethylene cement plug restrictor or a polyg lycolide lactide cement plug restrictor, Peak pressures in the proximal, mi d, and distal portions of the cement mantle were recorded during cement ins ertion, cement pressurization, and implant insertion, There was no differen ce between the two plug groups in peak pressures throughout the cement mant le during cement insertion, pressurization, or implant insertion. Total hip arthroplasty using a cementless acetabular component and a cemented femora l stem was performed in 24 dogs, The femoral intramedullary canal was plugg ed with a polyethylene or a biodegradable cement plug restrictor. The dogs were sacrificed at 7 weeks, 10 months, or 15 months. Radiographically, no o steolytic lesions were seen around either plug type. Histomorphometrically, the polyglycolide lactide plugs appeared intact at 7 weeks and partially d egraded by 10 and 15 months. Ln both plug groups, a mild fibrohistiocytic r eaction with infiltration of fibrocytes, histocytes, and endothelial cells was seen. No osteolysis was observed. The results of the current study show that femoral cement pressurization can be attained in vitro using a biodeg radable cement plug restrictor and that for as long as 15 months in the in vivo canine model there were no adverse reactions associated with use of th ese plugs compared with conventional ultrahigh molecular weight polyethylen e plugs.