Complete replacement of the joint without cement
Having many instances of loosening Hmtsl between the cement and the bone because of the reason of failure in the cement robes and difficulty in making perfectly cement insertion, brought back and developed the old system without cement that was used before the preparation of the cement system by Charnley.
Austin Moore in the US in the 40s of the last century, developed femoral head replacement without cement and in the 60s, Ring from England, developed a complete replacement of the joint without cement. Since then, there has been a technological revolution in metals and surface processing of metals which allows the growth of bone above and inside tiny crevices on the surface of the metal which, actually, causes a very stable fixation of the implants.
The metal used for the purpose of fixing the non-cement is usually titanium – Sometimes with a thin covering of hydroxyapatite, the mineral material which the bony part of the bone, is built from it.
Today, the method without bone cement is used more and more. Surgical technique is easier, faster and avoids an extremely rare complication (but dangerous) of breakdown of the cardiovascular when inserting cement the within the femur in pressure.
Another problem with the use of methods without cement (Complete replacement of the joint without cement) is “hip pain”: pain that appears rarely in the thigh when using prosthesis in hip without cement.
There are forms of implants in which “hip pain” is almost unknown.
For bone quality: there is no consensus – there are a considerable group of surgeons who take decisions when to limit the use of the method without cement, even when the Forotit is weak. Others have a contrary opinion and require a good bone quality on account of using this method.
Today, the method without cement (aka Complete replacement of the joint without cement) is a good choice especially for younger patients and / or patients who are physically active, using metal or ceramic bearing.