Cement-in-cement technique of the femoral component in aseptic total hip arthroplasty revision: A systematic review of the contemporary literature

Michael-Alexander Malahias; Fabio Mancino; Amil Agarwal; Leonidas Roumeliotis; Alex Gu; Ioannis Gkiatas; Danilo Togninalli; Vasileios S Nikolaou; Michael M Alexiades

doi:10.1016/j.jor.2021.06.002

Cement-in-cement technique of the femoral component in aseptic total hip arthroplasty revision: A systematic review of the contemporary literature

J Orthop. 2021 Jun 30:26:14-22. doi: 10.1016/j.jor.2021.06.002. eCollection 2021 Jul-Aug.

Authors

Affiliations

¹ The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA.
² Department of Orthopedics and Traumatology, Clinica ARS Medica, Via Grumo 16, 6929, Gravesano, Ticino, Switzerland.
³ Division of Orthopaedics and Traumatology, Department of Aging, Neurological, Orthopaedic and Head- Neck Studies, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
⁴ Università Cattolica del Sacro Cuore, Rome, Italy.
⁵ Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, 2300 M St NW, Washington, DC, 20037, USA.
⁶ Department of Trauma and Orthopaedics, Hampshire Hospitals NHS Foundation Trust, Basingstoke, Hampshire, UK.
⁷ 2nd Orthopaedic Department, School of Medicine, National and Kapodistrian University of Athens, Greece.
⁸ Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA.

Abstract

Background: Clinical outcomes of cemented femoral stems revisions using the cement-in-cement technique in aseptic conditions after total hip arthroplasty have been widely described.

Methods: The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried.

Results: Twelve articles were included (620 revision THA). Revision rate for complications related to the femoral side was 1.4% at mid-term follow-up (5.4 years). Periprosthetic femoral fracture rate was 1.1%, aseptic loosening of the femoral component 0.3%.

Conclusions: Cement-in-cement revision technique of the femoral component is associated with a high mid-term success rates (98.6%) and is potentially less challenging than other revision techniques.

Keywords: Aseptic loosening; Cement-in-cement; Cemented THA; Femoral revision; THA revision.

Publication types

Review