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IMPROVED CEMENTING TECHNIQUE – INTERFACE BIOACTIVE BONE CEMENT (IBBC)



Abstract

One of the drawbacks of cemented total hip arthroplasty (THA) is aseptic loosening after long period, major reason for which is bioinertness of PMMA bone cement. To improve longevity of THA, interface bio-active bone cement technique combined with modern cementing technique has been used in our institute, and was evaluated clinically and radiologically.

The present study includes 44 cases of primary THA with an average age at operation of 64 years old (ranging 48 to 81). Mean postoperative follow up period was 4 (ranging 3.5 to 5) years.

Pre- and postoperative evaluation using Merle d’Aubigné score were 8.0 and 16.2 points, respectively. Postoperative cementing grade using Barrack’s classification was A or B. At final follow up, radiolucent line at bone-cement interface was not observed, except one case of rheumatoid arthritis patient at zone 3 described by Delee and Charnley in the acetabular side. Neither osteolysis nor loosening was observed in every case. No major complications, such as infection, dislocation, pulmonary embolization, were observed.

The present study revealed excellent short-term result was obtained by IBBC technique combined with modern cementing technique for primary THAs. Most important technical point required for IBBC is to obtain dry bony surface just before cementing. Compressive reamed bone and gauze packing was effective for complete hemostasis just before cementing for the acetabular side, and plugging the isthmus using bone chips was effective for reducing bleeding for the femoral side.

Correspondence should be addressed to ISTA Secretariat, PO Box 6564, Auburn, CA 95604, USA. Tel: 1-916-454-9884, Fax: 1-916-454-9882, Email: ista@pacbell.net