Improved cementation in total hip replacement

Insufficient cementation has been suggested to be the most common cause of loosening of the femoral component after total hip arthroplasty. A clinical and radiographic study of 129 consecutive, primary total hip replacements was performed 5 years after surgery, in order to evaluate the significance of femoral plugging, special attention being focused on cementation and radiographic loosening. A polyethylene medullary plug was used in 78 hips which were compared with 51 non-plugged hips with respect to the clinical course and radiographic appearance. The cement mantle around the femoral component was thicker, and the packing of cement significantly improved when the plug was used. The frequency of radiographic loosening was smaller in the plugged group but with no statistical significance. There was no difference in clinical results between the compared groups. Our results indicate that medullary plugging improves the cementation and in particular prevents insufficient cementation of the femoral component.