Abstract
Cement pressurisation is an important step in total hip arthroplasty that determines the long-term integration at the cement-bone interface. Our aim was to evaluate the performance of a new pressuriser designed by us against the standard existing pressurisers in an in vitro experimental set-up using two parameters: cement penetration and cement pressurisation. A polypropylene cup model was designed to represent the acetabulum. DePuy’s T-handle, Exeter and our own plunger type pressuriser were each tested for cement pressurisation in this acetabular model. Cement penetration and pressures were measured. The cement intrusion into the capillaries with the DePuy pressuriser was found to vary between 2 and 8 mm (mean: 5 mm at the pole and 4.6 mm at the rim), with the Exeter pressuriser it varied between 3 and 9 mm (mean: 5.8 mm at the pole and 7.8 mm at the rim) and with the plunger type pressuriser it varied between 4 and 6 mm (mean 5.2 mm at the pole and 4.8 mm at the rim). The peak pressure achieved with the DePuy pressuriser was 60 kPa whereas it was 70 kPa with the plunger type pressuriser. The mean penetration with the plunger type pressuriser was found to be better than the other types. The penetration was found to be more uniform with equal penetration at the rim as well as at the pole.
Résumé
La pressurisation du ciment est une étape importante dans la prothèse totale de hanche qui peut déterminer une bonne intégration, à long terme, des implants, notamment à l’interface ciment-os. Le but de notre étude est d’évaluer les performances d’un nouvel appareil destiné à pressuriser le ciment, en comparaison avec l’appareil préexistant, cette comparaison étant réalisée au cours d’une étude expérimentale in vitro avec étude de deux paramètres, la pénétration et la pressurisation du ciment. Une cupule en polypropylène a été fabriquée comme modèle d’accétabulum. Nous avons ensuite mesuré la pénétration et la pressurisation du ciment, nous avons utilisé trois appareils, le porte cupule Depuy, l’appareil d’Exeter et notre propre appareillage. Résultats: l’intrusion du ciment dans les capillaires avec le porte cupule Depuy a été de 2 à 8 mm, avec l’appareil d’Exeter de 3 à 9 mm et avec notre nouvel appareillage de 4 à 6 mm. Le type de pression avec l’appareil porte cupule Depuy a été de 60 kPa alors qu’il était de 70 kPa avec notre nouvel appareillage. En conclusion: la pénétration moyenne avec notre nouvel appareillage a été nettement améliorée si on la compare aux autres types d’appareillage. Cette pénétration a été plus uniforme que se soit au pourtour de la cupule ou au niveau des pôles.
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Wadia, F., Malik, M.H.A., Leonard, D. et al. Cement pressurisation in the acetabulum. International Orthopaedics (SICO 30, 237–242 (2006). https://doi.org/10.1007/s00264-006-0101-3
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DOI: https://doi.org/10.1007/s00264-006-0101-3