An in Vitro Comparative Study of the Performance of Different Commercially Available Intramedullary Femoral Plugs during Total Hip Replacement

Distal flow of polymethylmethacrylate (PMMA) bone cement during insertion of the femoral implant results in reduced pressure and cement-bone interdigitation (Markolf, Amstutz, 1976). Insertion of femoral cement plugs in the intramedullary canal to prevent distal flow of PMMA cement in total hip replacement during cementing of femoral prostheses is well accepted and has become current practice (Prendergast et al., 1999). As a result, many designs of cement plugs exist on the market. The aim of this study is design an experimental set-up to compare the performance of the following four designs of cement plugs: (a) REX (Aone Medical B.V.), (b) Hardinge (DePuy), (c) Amber Flex (Summit Medical Ltd) and (d) Cemlock (Sulzer). This was done by recording data of proximal and distal pressures and migration of the cement plugs during cement pressurisation and insertion of the femoral prosthesis in prepared Sawbone femurs.