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In hip revision arthroplasty, removing a cemented acetabular component is often an arduous and time-consuming process which may damage the acetabular bone stock.1 We report an efficient, bone-preserving technique to remove a primary cemented socket along with its cement mantle using the Explant (Zimmer Ltd, Swindon, UK), a device originally designed for removing uncemented sockets.2
The Explant has a range of head sizes to fit inside the primary socket, and an adjustable curved blade which cuts circumferentially around the prosthesis. The blade used should match the diameter of the cement mantle. Working systematically through 360°, an interval is made between the cement mantle and the underlying bone. Once the cement-prosthesis construct is loose, it is gently levered out with an osteotome. We find that almost all the cement comes out in one piece, with the socket still embedded (Fig. 1). Where there are multiple cement anchoring holes, some cement fragments may remain; these are readily removed with a narrow osteotome.
We have used this technique in five sequential patients to remove cemented acetabular components, four of which were well fixed. The average time taken was 8 min (range, 3–13 min). In each case, the component came out with most of the cement mantle attached. There was little bone loss. In all cases, an uncemented revision socket was implanted, with additional bone graft in one patient. Postoperative radiographs were all satisfactory. This is now the senior author's favoured method for extracting a well-fixed cemented acetabular component.