Histomorphometric Analysis of Bone-Cement and Cement-Metal Interface

Bone cement primarily functions by filling the free space between the prosthesis and the bone. The connection between the cement and the bone and between the cement and the prosthesis has been repeatedly and intensively studied since cement was introduced for use with hip arthroplasty. The irregularities of the bone surface and the penetration of the cement into the trabecular spongiosa are an important prerequisite for long-term survival of the implant.16 Loosening of cemented femoral components occurs either at the cement-prosthesis interface—and eventually at the bone-cement interface—or directly at the bone-cement interface, which is basically a biomechanical and biological phenomenon. Identification of the sequence of events that initiate and lead to loosening is important in the effort to improve the survivorship of prosthetic components. In this respect, morphological evaluations of cemented femoral components are essential for the evaluation of the biological and mechanical responses to the prosthesis.14,22