What is a cemented prosthesis?

When a patient suffering from chronic joint pain due to arthritis chooses joint replacement surgery, an orthopaedic surgeon will replace the existing joint surface with an artificial joint prosthesis.These prostheses, or prosthetic components, must adhere to the patient's natural bone.The type of prosthesis used for this adhesion：

• Cementless joint prostheses, sometimes called compression prostheses, have special textures to allow bone to grow on top and adhere to them over time.

• Cemented joint prostheses use quick-drying cement to help stick to the bone.

Before a knee replacement, hip replacement, or other joint replacement surgery, the surgeon talks with the patient to decide whether to use a cemented implant, a cementless implant, or a combination of the two. The type of components used may depend on the patient's physiology, the type of surgery performed, and the surgeon's preference.

Cemented prosthesis is designed to have a layer of bone cement, typically an acrylic polymer called polymethylmethacrylate (PMMA), in between the patient's natural bone and the prosthetic joint component. Cementless prosthesis, also called a press-fit prosthesis, has a rough surface or porous coating that encourages the natural bone to grow onto it.

Advantages of Cemented Joint Prosthesis：

• Bone cement allows surgeons to attach artificial joint components to bone that is slightly porous due to osteoporosis.

• Small amounts of antibiotic material can be added to bone cement to help reduce the risk of infection after surgery.

• The cement dries within 10 minutes of use, so surgeons and patients can be confident that the prosthesis is firmly in place.

Disadvantages of cemented prostheses:

• A breakdown of the cement can cause the artificial joint to come loose, which may prompt the need for another joint replacement surgery (revision surgery).

• The cement debris can irritate the surrounding soft tissue and cause inflammation.

• While rare, the cement can enter the bloodstream and end up in the lungs, a condition that can be life-threatening. This risk is greatest for people who undergo spinal surgeries.

In rare cases, patients have an allergic reaction to the bone cement and must undergo a second surgery to remove the glue and prostheses.Not all patients with bone cement debris experience symptoms. Bits of cement debris can be removed arthroscopically to alleviate or prevent symptoms.

Advantages of cementless prostheses:

• More surgeons believe that cementless components provide a better long-term bond between the prosthesis and the bone.

• Cement-free components eliminate concerns about the potential decomposition of cement.

Disadvantages of cementless prostheses:

• Press-fit prostheses require healthy bones. Patients with low bone density due to osteoporosis may not be eligible for these components.

• It can take up to three months for bone material to grow into a new joint component.

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