Total hip revision arthroplasty. Prosthesis and cement removal techniques.

A modified technique for the removal of cemented total hip components and methylmethacrylate has been presented. This format utilizes manual tools and low-speed drills, reamers, and end mills. The advantages are safety, predictability, shorter learning curves, and cost effectiveness. Problems encountered with the dulling of manual tools used against methylmethacrylate are addressed by conversion to modular tools with readily replaceable working tips made of high-speed, hardened stainless steel. Safety and efficacy are facilitated by utilization of a step-cut technique of cement removal and fixed-point orientation at the distal cement column.