Computer-assisted femoral cement removal in revision total hip arthroplasty

摘要

Objectives: To describe a computer-assisted technique for femoral cement removal using fluoroscopic navigation. Background: In revision arthroplasty, the removal of femoral well fixed polymethylmethacrylate can be extremely demanding, time consuming and damaging to the remaining host bone. Available methods involve using a combination of chisels, power burrs and drills as well as windowing the femoral cortex, ultrasound, laser and extracorporeal shock wave therapy [1, 2, 3, 4, 5, 6]. This techniques are associated with femoral fracture or uncontrolled cortical perforation and bone loss. Design/Methods: Ten plastic femurs and five clinical cases involving revision of cemented femoral components were analyzed using this system. This method works with fluoroscopic navigation of a motorized drill guide that perforates the center of the distal plug, followed by a navigated cannulated intramedullar reamer. Results: Complete cement removal was achieved in all the cases without damage to the femur. Additional information concerning statistically significant differences in operative time in the clinical cases will be presented at the meeting. Conclusions: Fluoroscopic navigation is a valuable adjunct for femoral cement removal in revision total hip arthroplasty. This reliable and safe method simplifies a challenging step in a complex operative procedure.