Recent advances in the treatment of hip fractures in the elderly.

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Abstract

Conflict of interest statement: Competing interests: The authors declare that they have no competing interests. No competing interests were disclosed. 20. Curr Rev Musculoskelet Med. 2021 Feb;14(1):47-59. doi: 10.1007/s12178-020-09681-5. Epub 2021 Jan 16. Femoral Stem Cementation in Hip Arthroplasty: The Know-How of a "Lost" Art. Emara AK(1), Ng M(1), Krebs VE(1), Bloomfield M(1), Molloy RM(1), Piuzzi NS(2). Author information: (1)Cleveland Clinic, Department of Orthopaedic Surgery, Cleveland, OH, USA. (2)Cleveland Clinic, Department of Orthopaedic Surgery, Cleveland, OH, USA. piuzzin@ccf.org. PURPOSE OF REVIEW: To describe the (1) indications, (2) preoperative precautions, and (3) stepwise technical details of modern femoral stem cemented fixation. RECENT FINDINGS: Femoral stem cementation provides excellent implant longevity with a low periprosthetic fracture rate among patients with compromised bone quality or aberrant anatomy. Unfamiliarity with the details of modern cementation techniques among trainees who may lack frequent exposure to cementing femoral stems may preclude them from offering this viable option to suitable patients in later stages of their careers. As such, maximizing benefit from cemented femoral stem fixation among suitable candidates is contingent upon the meticulous use of modern cementation techniques. In addition to proper patient selection, modern cementation techniques emphasize the use of (1) pulsatile lavage of the femoral canal, (2) utilization of epinephrine-soaked swabs, (3) vacuum cement mixing, (4) retrograde cement introduction, (5) cement pressurization, and (6) the use of stem centralizers. Furthermore, identifying and optimizing the preoperative status of at-risk patients with pre-existing cardiopulmonary compromise, in addition to intraoperative vigilance, are essential for mitigating the risk of developing bone cement implantation syndrome. Further research is required to assess the utility of cemented femoral stem fixation among younger patients. DOI: 10.1007/s12178-020-09681-5 PMCID: PMC7930165