The quality of technique used at the time of socket cementation is crucial in ensuring a durable long-term result of the implant.
We asked whether a new instrument, an aspirator retractor introduced into the wing of the ilium before socket preparation
and cementation, would enhance cement fixation as defined by RSA and radiographic examination. We randomized 38 patients into
two groups. The surgical technique was identical between the groups with the exception of the use of the aspirator retractor.
Patients were followed clinically and with radiostereometry at a minimum of 2 years. We compared gross radiographic appearances,
including the depth of penetration of cement and the incidence of postoperative and 2-year radiolucent lines. There was no
difference in proximal migration between the two groups. No improvement of fixation was proven from the measured translations
and rotations of the socket in the suction group. We found no difference in the number or extent of radiolucent lines or the
depth of cement penetration when the iliac suction device was used in conjunction with contemporary cementing techniques.
Although the data suggest no short-term advantage in this small study, we will continue to follow these patients presuming
there will be improved outcomes in the longer term and since the device provides an easier method of obtaining adequate fixation,
especially if technical difficulties are encountered during the pressurization procedure.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations
were conducted in conformity with ethical principles of research, and that informed consent for participation in the study
was obtained.