Krause, MatthiasMatthiasKrauseBreer, StefanStefanBreerHahn, MichaelMichaelHahnRüther, WolfgangWolfgangRütherMorlock, MichaelMichaelMorlockAmling, MichaelMichaelAmlingZustin, JozefJozefZustin2024-03-122024-03-122012-01-11International Orthopaedics 36 (7): 1333-1340 (2012)https://hdl.handle.net/11420/46368Purpose: The use of inappropriate cementation techniques has been suggested as an adverse factor for the long-term survival of hip-resurfacing arthroplasty. Inadequate initial fixation, thermal osteonecrosis and interface biological reactions are possible causes of failure. We analysed morphological changes associated with the cementation technique in a large collection of retrieved femoral components. Methods: One hundred and fifty femoral components (mean time to failure of 8.3 months±11.0) obtained at revision surgery were analysed morphometrically and histopathologically. Cement mantle and penetration were quantified in six different regions of interest. Histopathological analysis of the bone-cement interface was performed on undecalcified processed bone tissue. Results: The vast majority of the cases differed substantially from laboratory-based cement-penetration depth recommendations. Fifty-nine cases had a fibrous membrane at the cement-bone interface. This membrane was significantly thicker in cases with osteonecrosis compared to cases viable bone. Conclusions: Our results demonstrate that most failures were cemented inappropriately. We suggest that poor cementation was an important adverse factor; however, the cause of the failures was obviously multifactorial. The thickness of the fibrous membrane at the cement-bone interface differed significantly between cases with osteonecrosis and specimens with viable bone tissue. © Springer-Verlag 2012.en1432-51952012713331340SpringerMedicine, HealthJournal Article10.1007/s00264-011-1464-7Other