Femoral Perforation during Cement Removal in Revision Hip Arthroplasty

Abstract

Eighty two cemented femoral revision hip arthroplasties were reviewed to assess the incidence of intraoperative perforation of the femur and subsequent periprosthetic fracture using a high speed pneumatic burr for the removal of acrylic bone cement with an extensile exposure. There was one case of intraoperative femoral perforation; this patient did not go onto fracture postoperatively. There were no cases of intraoperative femoral fracture. There were 3 cases of periprosthetic femoral fracture all of which occurred more than 12 months after their impaction grafted femoral revision arthroplasty using a standard length cemented stem.

The pneumatic high speed burr was extremely effective in the removal of acrylic bone cement in femoral revision arthroplasty. The incidence of subsequent femoral fracture in the impaction grafted revised population was low and did not appear to be related to intraoperative femoral perforation.