Cemented Total Hip Replacement Surgery Abroad At Affordable Cost

Over the past 40 years, there have been many improvements in both the materials and the methods used to hold the femoral and acetabular components in place. Today, the most commonly used bone cement is an acrylic polymer called polymethylmethacrylate (PMMA).

A patient with a cemented total hip replacement can put full weight on the limb and walk without support almost immediately after surgery, resulting in a faster rehabilitation. Although cemented implants have a long and distinguished track record of success, they are not ideal for everyone...

Cemented Total Hip Replacement in Abroad

Cement fixation has a 30-year history in total hip arthroplasty. Cement fixation is a durable and reproducible means of fixation in a variety of hips. A key determinant to a cement mantle’s longevity is the technique of cementing. This article reviews what has been learned in the past and outlines the state of the art in cement technique today.

One of the relatively recent changes in cement and arthroplasty is that a multitude of cements are available on the market. Although the durability of well-made cement mantles around implants is fairly consistent among cements, the products differ in terms of viscosity, working time, and setting. A surgeon must know the details of the particular cement he or she intends to use, as it will influence the cement technique. Working time and setting time vary among the different cements...

Cementing Technique

Bone preparation is critical for long-term survivorship of both the cemented stem and the cup.4 The aim is to provide a clean, stable bony bed for cement interdigitation into the remaining cancellous bone and to maintain stable interfaces between the implant and cement, and the cement and the bone.

Most investigators would agree that a surgeon should remove all loose cancellous bone but leave the remaining dense bone nearest to the cortex to enhance interdigitation of the cement into the remaining bone. This increases the shear strength of the cement and gives the best contact of the cement mantle to the remaining bone stock. Reaming with cylindrical or tapered reamers in the femur is often performed to remove the loosest bone but should be done by hand to leave a remnant of cancellous bone. It is important not to ream away all cancellous bone, as this will leave a smooth inner cortex and diminish the ability for the cement to bond to the bone...

Acetabulum

On the acetabular side, the concepts are similar to the femur; removal of loose cancellous bone, cleaning of bony surfaces, and pressurization of cement into the bony bed. The bone should be reamed until cancellous bone is visualized and special attention should be paid to bone preparation and pressurization in zone 1.14,15 All pelvic cysts should be curetted, cleaned, and grafted. Anchor holes should be placed into the bone to improve long-term fixation.

The bone should be dried. However, drying the bone is difficult to achieve on the acetabulum, as there is no canal to plug to limit bleeding. Sponges with a low concentration of thrombin have been used in the past...

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