Manual of Cementing Technique

1 Historical Background.- 1.1 Conditions Before Charnley.- 1.2 John Charnley.- 2 Histomorphology of the Bone-to-Cement Contact.- 2.1 The Cemented Total Hip Arthroplasty.- 2.2 Histomorphology of the Bone-to-Cement Contact (Animal Experiments).- 2.3 Histomorphology of Human Samples.- 3 Can Cancellous Bone Carry the Load?.- 3.1 About the Deformation Behavior of Spongiosa.- 3.2 Deformation of Bone Through Different Implants.- 3.3 Stiffening of Spongiosa with Bone Cement.- 4 Approach to the Hip Joint.- 4.1 Posterolateral Approach.- 4.2 Transgluteal Approach.- 5 Preparation of the Acetabulum.- 5.1 Preparatory Steps.- 5.2 Exposure of the Acetabulum.- 5.3 Fossa Acetabuli.- 5.4 Preparation of the Bony Acetabulum.- 5.5 Anatomical Composition of the Joint Surface of the Acetabulum.- 5.6 Lavage, Anticoagulation and Stiffening of the Acetabular Roof.- 5.7 Inclination and Alignment.- 6 Preparation of the Bone Cement.- 6.1 Advantages of Standard Viscosity Bone Cement.- 6.2 Cold Storage as a Simple Method To Achieve a Temporarily Lower Viscosity.- 6.3 Homogeneous and Bubble-Free Mixture.- 6.4 Prepressurizing Bone Cements, a Conditio Sine Qua Non.- 6.5 Application of the Bubble-Free Bone Cement.- 7 Preparation of the Femur.- 7.1 Opening of the Medullary Canal and Implantation Axis.- 7.2 Surgical Diamond Instrumentation.- 7.3 Drainage of the Medullary Canal.- 7.4 Preparation of the Implant's Bed.- 7.5 Lavage.- 7.6 Plugging the Medullary Cavity.- 7.7 Heparinization, Cementation, and Implantation.- 8 Scientific Background of Vacuum Application.- 8.1 The Problem of Thromboembolism and Drainage of the Medullary Canal.- 8.2 The Distal Drill Hole.- 8.3 The Stem-Canal Volume Relationship.- 9 Consideration of the Prosthetic Design of the Femoral Stem.- 9.1 Stiffening Spongiosa of the Femur.-9.2 Calcar Femoris.- 9.3 Stem Design.- 9.4 Preoperative Planning.- 9.5 Centralizing Anatomical Design.- 10 Instrumentation.- 11 Conclusions: The Success of Cemented Components.- 11.1 First-Generation Cementing Techniques.- 11.2 Success of the Cemented Component Is Due to Stiffened Bone Structures.- 11.3 Cancellous Bone Stiffened by Bone Cement Can Survive.- 11.4 Preservation of Cancellous Bone.- References.- Author Index.