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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 9, 1252-1256.
doi: 10.1302/0301-620X.88B9.17538  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Uncompromised quality of the cement mantle in Exeter femoral components implanted through a minimally-invasive direct anterior approach

A PROSPECTIVE, RANDOMISED CADAVER STUDY

E. Mayr, MD, Orthopaedic Surgeon1; M. Krismer, MD, Professor, Orthopaedic Surgeon1; M. Ertl, MPh, Statistician1; O. Kessler, MD, Orthopaedic Surgeon2; M. Thaler, MD, Orthopaedic Surgeon1; and M. Nogler, MD, Associate Professor, Orthopaedic Surgeon1

1 Department of Orthopaedic Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
2 Stryker Europe, Scientific & Clinical Affairs, Florastrasse 13, CH-8800 Thalwil, Switzerland.

Correspondence should be sent to Dr E. Mayr; e-mail: eckart.mayr{at}uibk.ac.at

A complete cement mantle is important for the longevity of a total hip replacement. In the minimally-invasive direct anterior approach used at the Innsbruck University hospital, the femoral component has to be inserted into the femoral canal by an angulated movement. In a cadaver study, the quality and the extent of the cement mantle surrounding 13 Exeter femoral components implanted straight through a standard anterolateral transgluteal approach were compared with those of 13 similar femoral components implanted in an angulated fashion through a direct anterior approach. A third-generation cementing technique was used. The inner and outer contours of the cement mantles was traced from CT scans and the thickness and cross-sectional area determined.

In no case was the cement mantle incomplete. The total mean thickness of the cement mantle was 3.62 mm (95% confidence interval 3.59 to 3.65). The mean thickness in the group using the minimally-invasive approach was 0.16 mm less than that in the anterolateral group. The distribution of the thickness was similar in the two groups. The mean thickness was less on the anteromedial and anterolateral aspect than on the posterior aspect of the femur.

There is no evidence that the angulated introduction of Exeter femoral components in the direct anterior approach in cadavers compromises the quality, extent or thickness of the cement mantle.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General