The insertion of bone cement particles did not elevate MOM rates of wear above normal.
One of the most popular is solid screw vertebroplasty, being the insertion of the cement into the pilot hole prior to placement of the screw [ 13, 15– 17, 21, 22, 41, 63].
The TTO remained stable after insertion of a cement spacer, but in the absence of internal fixation probably because of the distal soft tissue attachment to the anterior compartment muscles.
The same cementing technique was used in both groups, including broaching of the femoral canal, insertion of a distal restrictor, and injection of cement (Surgical Simplex or Antibiotic Simplex P; Stryker, Howmedica, Osteonics).
The intramedullary pressures were continuously recorded, beginning approximately 2 min before the injection of cement into the canal and ending when the intramedullary pressure returned to 0 (approximately 2 min after insertion).
The insertion of an intramedullary cement restrictor can lead to the same pathophysiologic reactions that are well described as fat embolism syndrome after cement and stem implantation.
Our basic principle was 2-stage revision: removal of implants, debridement, and insertion of antibiotic-impregnated cement spacers in the first stage and implantation of new prostheses in the second stage (Koo et al. 2001).
While femoral neck fractures treated via cemented hemiarthroplasty may be less prone to periprosthetic fracture and prosthetic loosening, they are also more likely to trigger embolisms and decreased cardiac output during insertion of the bone cement.
Most reports (55/62, 89%) describe acute deterioration occurring during or within a few minutes of cement insertion.
Immunological mechanisms such as histamine release, complement activation and endogenous cannabinoid-mediated vasodilation at the time of cement insertion have also been implicated.
