[Clinical results of the use of ultrasonic bone cement extractor in revision arthroplasty in oncology].

PURPOSE: To investigate beneficial advantages of the ultrasonic method of bone cement removing in, compare with mechanical as well as to qualitatively improve the technology of bone cement removing in revision arthroplasty. MATERIAL AND METHODS: The study included 55 patients with benign, primary and metastatic malignant tumors. From March 2014 to January 2016 there were performed 56 revisions. In 36 cases revisions were made using ultrasound system <>. The quality of stem fixation was evaluated radiologically. RESULTS: Mean follow-up after surgery was 11.5 months. One patient had second revision after mechanical extraction of bone cement due to aseptic loosening. In the group of patients after ultrasonic extraction of the cement mantle deterioration of the cement fixation was not revealed. The average time.of surgery using ultrasonical and mechanical technology of bone cement removal was 154.5 and 158.1 min. in replacement of one stem, 200 and 182 min. in replacement of two stems respectively. The average blood loss was 427 and 430 ml. in a time of one stem revision, 445 and 525 ml in a time of two stem revision after using ultrasound and mechanical technol- ogy respectively. In one stem revision with using ultrasound extractor was achieved the reduction in blood loss at 10% and in two stem revision at 16%. There were no any complications in using ultrasonic extractor. CONCLUSION: The use of ultrasonic technology in the re- vision arthroplasty can improve the quality of cement fixa- tion, reduce the amount of bleeding and severity of surgical treatment regardless of the surgery time, improve economic efficiency. Further enhancement of the ultrasonic method for cement mantle extraction has a potential to improve its effectiveness.