Failure of the cement-bone interface. A consequence of strengthening the cement-prosthesis interface?

We report the early failure, at a mean of 37 months, of 17 femoral prostheses due to aseptic loosening at the cement-bone interface. In every case the prosthesis had been manufactured with a surface coating designed to enhance the strength of the cement-prosthesis interface. It is postulated that improving the bond at the cement-prosthesis interface may transfer increased stress to the cement-bone interface and cause early failure at that interface.