Effectiveness and safety of a cement-on-cement removal system for hip and knee arthroplasty revision surgery.

Cement removal during hip or knee arthroplasty revision is challenging and not exempt of complications. Cement-on-cement procedure is among techniques developed to safe removal of cement from bone, and it could be a realistic solution. This cement-on-cement devices can provide advantages in removing bone cement during hip and knee arthroplasty septic and non-septic revision surgeries, and can be regarded as an effective and safe alternative. We present our experience using the cement-on-cement technique in 34 cases between 2010 and 2021, including revision surgeries for 20 knee and 14 hip arthroplasties. In 3 out of 34 cases the technique failed, with a success of 91%. Mean surgical time was 2.77 (SD 0.93) hours and blood transfusion was required in 23 cases. Success was achieved in every aseptic case. Of all patients, 60% were septic cases. Infection was considered to be eradicated in 70% (14/20) of patients with a septic revision. Cement-on-cement is a safe and effective alternative for cement removal during hip and knee arthroplasty revision. Level of evidence: III, retrospective case series.

Surgical Technique of a Cement-On-Cement Removal System for Hip and Knee Arthroplasty Revision Surgery.

Cement removal during hip or knee arthroplasty revision surgery is technically demanding and prone to severe complications such as periprosthetic fractures, incomplete cement removal, or perforations. Several alternative techniques have been developed to enable complete, accurate, and safe removal of cement from bone, including osteotomies and cortical windows, endoscopic instruments, ultrasound devices, lithotripsy, and laser-assisted removal. We describe a cement-on-cement technique with a sterile, single-use tool for cement removal. The cement is removed piece by piece using a specifically designed device, without osteotomies or cortical windows.