Abstract:

In revision arthroplasty the surgeon is often faced with the problem of removal of residual cement in the medullary canal. Conventional manual cement removal by hand or power-driven instruments can be time-consuming, can require osteotomy, and can be associated with complications such as cortical perforation, fracture, or bone loss. Ultrasonic devices offer an alternative method of cement removal, but the potential for thermal injury exists, in particular for the humerus and the radial nerve. Considering these problems with the use of ultrasound, and whereas the old cement mantle may be left in place in the hip or knee but not in the shoulder, we tried this new mechanical cement extractor also in the humerus. We utilized this extractor in 5 cases, and we eliminated all residual resin in an accurate and complete way without bone loss and without iatrogenic fractures in all cases. We believe this system, which was designed for revisions of hip and knee surgery, is also suitable for the shoulder.

Authors:

Stefano Giannotti, MD, Specialist in Orthopaedics and Traumatology, Vanna Bottai, MD, Specialist in Orthopaedics and Traumatology, Giacomo Dell’Osso, MD, Specialist in Orthopaedics and, Traumatology, Giulia Bugelli, MD, Resident in Orthopaedics and Traumatology, Giulio Guido, MD, PhD, Ordinary Professor of Orthopaedics and, Traumatology, IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy

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