Advantage of the transprosthetic drainage system (TDS) for application in cemented hip arthroplasty--a standardized experimental comparison with other cementing techniques.

We constructed a computer-assisted implantation device to compare different cementing techniques of stem implantation in total hip arthroplasty, thus avoiding any manual influence during implantation. We used an intramedullary plug in each case. Conventional cementing techniques, employing an additional lateral drain for the femoral canal or applying the cement by hand, did not lead to a satisfyingly reproducible quality of the cement mantle. With the vacuum cementing technique, in which an additional cannulated screw is inserted into the plug from the lateral side of the femur for the application of the vacuum, the cement mantle improved in quality, but there was still a relatively high number of bubbles incorporated in the cement. We think that, even under improved experimental circumstances, it is not always possible to place the cannulated screw correctly into the plug in order to achieve a satisfying drainage of the femoral canal with this procedure. The transprosthetic drainage system showed the best results due to the optimized position and working capacity of the drain.