Biomet Cement and Cementing Systems

Vacuum Mixing & Delivery

Cement delivery and retrograde filling

Applying cement under pressurization increases the cement’s interface strength.^13,30 For this reason, a cement delivery gun is recommended.

Pressurization affords better cement penetration into bone irregularities, ensuring a strong bone cement bond. The insertion of cement into a plugged canal with a pressurized delivery system represents a major advance. By contrast, the insertion of cement by hand often results in blood entrapment, laminations, incomplete filling and possibly embolization of air and other canal contents into the venous circulation.

The Swedish Hip Registry has shown that retrograde cement filling in the femur reduces risk of revision.³¹ It is recommended to inject the cement in retrograde fashion, letting the cement gun work its own way out of the femur. A long nozzle should be used in order to reach the distal plug. This technique eliminates air entrapment during cement application, also preventing cement porosity from occurring. Lamination of the cement is also avoided, making it possible to achieve a completely cement-filled cavity. In order to minimize lamination of the blood, the cement is normally applied 2–4 minutes after the start of mixing (depending on type of cement).

Ideally, acrylic cement should be introduced into the plugged canal distally, filling it in a progressively proximal direction. The cement should be introduced as close as possible to the bone surface, preventing the intermixture or entrapment of blood or air.

Picture showing cement delivery in a retrograde fashion.