Aseptic loosening of cemented femoral stems results from migration of wear particles along the bone-cement interface, producing a foreign body reaction. After cement insertion, blood back pressure can disrupt the bone-cement interface, enabling this spread of wear particles. Our study investigates whether altering timing and speed of stem insertion can reduce this risk. We inserted mock “C-Stem” femoral components (De Puy-Synthes), using Smartset HV cement (De Puy-Synthes) into artificial femora, fitted with proximal and distal pressure transducers. Cement insertion began two, three or four minutes after mixing. Cement pressures were then allowed to settle for one minute and the stems were then inserted over durations of 25, 60 or 90 seconds.Background
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