Cemented Femoral Fixation: Thin Mantles, The French Paradox

A review of the results of 964 cemented stems has been performed with a 24-year follow-up. Three different stems were used, two being cobalt chrome and one a titanium alloy. The current stem has a modular neck to allow version change after cementation. The cementing technique is to ream lightly and trial with a stem large enough to give rotational resistance without cement. When cement is introduced, this large stem pressurizes the cement to completely fill the canal. Six cases only (0.6%) were revised for aseptic loosening. It is concluded that with this cement technique and with appropriate patient selection cement is still a reasonable option in the elderly with wide canals.