Cement Removal with Ultrasonically Driven Tools in Revision Total Hip Prosthesis A Report of Two Cases

Abstract

Cement removal during revision total hip arthroplasty, especially removal of the distal cement plug in the intramedullary canal, can be a tedious, time-consuming process. The usual methods for removing cement include high-speed drills, chisels, saws, and reamers, which are often associated with fracture and perforation of the femoral shaft. Recently, ultrasonically driven tools have been becoming available for revision hip surgery. In two cases of aseptic loosening of the cemented femoral stem, we used this device for removal of cement from the intramedullary canal without femoral cortical windows or trochanteric osteotomy. There were no intraoperative femoral fractures or inadvertent femoral perforations during cement removal, and the cemented femoral stems were revised to noncemented implants. Ultrasonically driven tools are able to reduce the incidence of perforation, the time for cement removal, and also intraoperative blood loss. These tools are useful for surgeons who are not expert in removing cement during revision surgery.