Orthopedic Surgery

The dramatic relief of pain and the return of function following implantation of a total-joint arthroplasty in the treatment of a patient with an arthritic hip or knee can be compromised by mechanical loosening of the acrylic cement-bone interface in up to 30% of patients.¹ The incidence of mechanical loosening of total-hip arthroplasty appears to increase with the passage of time. The pain associated with mechanical loosening has necessitated revision arthroplasty in at least half of these patients. But recent advances in the management of acrylic bone cement (centrifugation or vacuum mixing and insertion in a low viscous state under pressure) and preparation of the proximal femur (jet lavage, plugging of the canal to ensure pressurization, and insertion of a precoated component) have lowered the incidence of mechanical loosening of the femoral component to 1% to 2%. The prosthetic components have also been redesigned and fabricated from new metals