We compared the penetration depth into cancellous bone when pressurizing cement at predetermined pressure levels, and at different times after cement mixing, in 21 arthrotic femoral heads during ...total hip replacement. To determine the influence of circulating blood on cement penetration, cement was injected into holes drilled into the femoral head before and after osteotomy of the femoral neck. The penetration of cement increased on the average 100 percent in the absence of circulation.
To improve cement penetration into the cancellous bone of the acetabulum in hip arthroplasty, sequential cementation of each anchoring hole may be feasible. Since this procedure creates laminations ...in the cement, we have determined the conditions under which such laminations affect the strength of the cement.
Cement bars made at 2, 3 or 4 minutes after the start of cement mixing and with either dry laminations or laminations including blood or saline were tested for tensile strength. Solid unlaminated bars were used as References. Dry and saline laminations made up to 4 minutes after the start of cement mixing did not reduce the strength of the cement. However, there was a time-dependent decrease in cement strength if blood was entrapped in the interface. In such cases, there was a decrease in strength for laminations made at 4 minutes, at 3 minutes this was less pronounced and at 2 minutes no weakening at all was noted.
Our findings indicate that a sequential cementation procedure is permissible as regards cement strength, provided it is performed within 2-3 minutes after the start of cement mixing. If the cement area is kept free from blood, the time may be prolonged up to 4 minutes, without the risk of weakening the cement strength.
