Does increased cement pressure produce superior femoral component fixation?

A new system of femoral cement pressurization is presented that attempts to produce sustained and elevated cement pressure. Five paired cadaver femora were pressurized with Simplex cement, and PFC femoral components were inserted. One of each pair was pressurized with the new system, and 1 was pressurized with an existing device. Pressure was recorded at the proximal and distal levels. After curing, all 10 specimens were sectioned at similar levels and subjected to push-out testing to failure. Specimens that achieved higher pressures and longer duration of pressures tended to show higher levels of failure (not statistically proven on 10 specimens). Cementing techniques that use higher pressurization of cement are recommended. It is mandatory, however, that the femur be thoroughly cleaned of fat before the application of these techniques to avoid a fat embolism syndrome.