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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 December;50(6):217-26
The use of cement in hip revision
D'Imporzano M., Castelli F.
Background. The positive results achieved with primary hip replacement using third generation cementing techniques have rekindled the debate concerning the use of cement in hip revision.
Methods. A retrospective study was made of 28 cases with a follow-up of at least 18 months treated using revision techniques with pressurized and cemented bone grafts and 32 cases treated using the ''cement in cement'' revision technique with a mean follow-up of 7.8 years. Femoral and cotyloid bone loss was reconstructed using pressurized and cemented homoplastic bone grafts in type 1 and type 2 GIR and in types 2 and 3 of GIR with the aid of metallic clips. In addition to the revision technique using pressurized and cemented bone grafts, the ''cement in cement'' revision technique was also used.
Results. In patients treated with pressurized and cemented bone grafts, the mean ''Harris hip score'' was 80/100. The level of bone loss did not influence clinical results. Complete graft integration was found in 18 patients (95%) over periods ranging between 6 and 18 months. An analysis of the ''cement in cement'' revision technique showed a quota of 5% undergoing reoperation. 95% of the patients treated obtained a good or excellent Harris hip score.
Conclusions. On the basis of clinical experience and from an analysis of the results obtained, the conclusion is drawn that the use of cement in hip revision represents a valid surgical solution in selected cases for the treatment of hip replacements affected by aseptic mobilization.