Femoral cementing techniques: current trends in the United Kingdom

INTRODUCTION: The results of a survey conducted amongst hip surgeons in Great Britain on the use of bone cement and femoral cementing techniques are reported. MATERIALS AND METHODS: A postal questionnaire was sent out to the members of the British Orthopaedic Association for their opinion on cement usage and femoral cementing techniques in primary hip arthroplasty. RESULTS: A majority of surgeons use high viscosity cement (82%) and cement containing antibiotics (77%). Almost a fifth of the respondents were unaware of the place of storage of the cement and of the ambient theatre temperature. Over two-thirds experienced inconsistencies in the handling of cement and attributed this to inconsistent theatre temperature (40%) and storage temperature (14%). A majority of the surgeons followed the 'modern' femoral cementing technique of vacuum mixing (94%), plugging the femoral canal (98%), pulsed lavage (87%), retrograde cement introduction (95%), use of stem centralisers (62%) and cement pressurisation. Four-fifths of the surgeons used time as a guide for cement and stem insertion rather than consistency of the cement. CONCLUSIONS: Though most of the surgeons follow contemporary cementing techniques, it appears that inconsistency of the working properties of the cement is a major impediment. Many surgeons are also unaware of the variables that can influence polymerisation and working time of the cement.