Successful joint replacement

Joint replacement is one of the most successful surgical procedures worldwide. The choice of bone cement is decisive for the long-term success of a cemented endoprosthesis. Register data and studies show that the choice of the right bone cement can contribute to the following aspects:

  • Lower revision rates:
    Up to -27% for the hip and up to -15.3% for the knee (1)
  • Optimal combination in infection prevention:
    The combination of local and systemic antibiotic prophylaxis achieves the best preventive results in arthroplasty: up to -30% lower revision rates in the knee and up to -50% in the hip (data related to primary procedures) (2-5)
  • Ideal cement intrusion:
    While too little intrusion can lead to an increased risk of aseptic loosening and revisions, a too deep intrusion can be associated with increased rates of heat necrosis and implantation syndrome (6-9)
  • Modern Cementing Technique:
    The combination of different elements is crucial to the long-term surgical outcome: the choice of the bone cement, bone bed cleaning, mixing of bone cement in a vacuum mixing system, retrograde application and application of pressure with a pressuriser

PALACOS® - The element of success in joint replacement

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Heraeus Medical's - Elements of Success
  • > 60 years in arthroplasty
    effective and permanent fixation of implants
  • used in > 30,000,000 procedures worldwide (10)
  • most studied bone cement
    (> 130 studies according to JBJS criteria) (11)
  • proven formula with many options

(1) NJR Data Supplier Feedback (summary reports); Cumulative revision rates at 15 years, all bearing types. Status February 2023. Current report available  here .
We thank the patients and staff of all the hospitals in England, Wales, Northern Ireland and the Isle of Man who have contributed data to the National Joint Registry. We are grateful to the Healthcare Quality Improvement Partnership (HQIP), the NJR Steering Committee and staff at the NJR Centre for facilitating this work. The views expressed represent those of Heraeus Medical GmbH and do not necessarily reflect those of the National Joint Registry Steering Committee or the Health Quality Improvement Partnership (HQIP) who do not vouch for how the information is presented.
(2) Jämsen E et al. J Bone Joint Surg Am. 2009 Jan;91(1):38-47.
(3) Espehaug B et al. J Bone Joint Surg Br. 1997 Jul;79(4):590-5.
(4) Parvizi et al. Acta Orthop. 2008 Jun;79(3):335-41.
(5) Kühn KD et al. Unfallchirurg 2017; 120:561-572.
(6) Vanlommel J.Cementing the Tibial Component in Total Knee Arthroplasty. J Arthroplasty 2011; 26(3):492-496.
(7) Huiskes, R., Slooff, T. J.: Thermal injury of cancellous bone following pressurized penetration of acrylic cement. Proc. Orthop. Res. Soc., Las Vegas, Nevada, February 1981, p. 134.
(8) Donaldson AJ, et al. Bone cement implantation syndrome. Br J Aneasth 2009; 102(1): 12-22.
(9) Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Insall Award Paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 2002; 404: 7-13
(10) Data on file
(11) Pilz, V., & Hanstein, T. (2018). A Literature Review of the Clinical Evidence Situation of Bone Cements. Research & Reviews: Journal of Medical and Health Sciences, 7(1), 31–36.