Percutaneous Femoral Cementation for Aseptic Hip Prosthesis Loosening: A Minimally Invasive Alternative

Purpose or Learning Objective: The increasing prevalence of hip arthroplasty has led to a rising number of cases requiring prosthetic revision surgery. For patients with aseptic loosening who are not candidates for revision surgery, percutaneous femoral cementation under fluoroscopic or computed tomography guidance has emerged as a minimally invasive alternative for stabilization. This study presents our experience with this procedure, evaluating its feasibility as well as its short- and long-term clinical outcomes. In addition, we highlight the technical aspects of percutaneous femoral cementation and its potential benefits for patients’ quality of life.

Methods or Background: Six patients (76–84 years of age; two men and four women) with symptomatic aseptic loosening of hip prostheses and radiologic signs of prosthetic loosening underwent percutaneous femoral cementation at our institution. The procedure involved percutaneous injection of polymethyl methacrylate mixed with antibiotics through a vertebroplasty needle, ensuring optimal cement distribution under fluoroscopic guidance. Polymethyl methacrylate was injected into the periprosthetic osteolytic cavity resulting from femoral stem loosening to provide mechanical stabilization. The intervention was performed under local anesthesia and sedation. Patients were clinically assessed before and after the intervention for pain relief and functional improvement, with a long-term follow-up conducted at 3 years.

Results or Findings: All procedures were successfully completed without complications, and no adverse events were reported. Short-term follow-ups after the procedure demonstrated significant pain reduction and improved mobility in all patients. However, at the 3-year follow-up, four of the six patients (66.67%) experienced a return to their baseline pain levels, indicating that although percutaneous femoral cementation provides effective short-term relief, its long-term durability may vary.

Conclusion: Percutaneous femoral cementation could be considered a viable alternative to surgical revision for patients with aseptic hip prosthesis loosening who are not candidates for prosthetic revision surgery. It offers substantial pain relief and functional benefits in the short term, with minimal procedural risks. Further studies with larger cohorts and extended follow-up periods are warranted to determine its long-term efficacy that appears to be variable. Additionally, percutaneous cementation could be explored for prostheses in other anatomical areas, such as the knee and shoulder.

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Artikel online veröffentlicht:
02. Juni 2025