Technical TricksPrevention of Hip Lag Screw Cut-Out by Cement Augmentation: Description of a New Technique and Preliminary Clinical ResultsSzpalski, Marek* ; Descamps, Pierre-Yves* ; Hayez, Jean-Pierre* ; Raad, Emmanuel* ; Gunzburg, Robert† ; Keller, Tony S.‡; Kosmopoulos, Victor‡ Author Information From the *Centre Hospitalier Molière Longchamp, Brussels, Belgium, †Euwfeestkliniek, Antwerp, Belgium, and ‡The University of Vermont, Burlington, Vermont. Accepted for publication January 8, 2003. Reprints: Dr. Marek Szpalski, 21 avenue Coghen, B-1180 Brussels, Belgium (e-mail: [email protected]). Journal of Orthopaedic Trauma 18(1):p 34-40, January 2004. Buy Abstract Cement augmentation of hip lag screws to avoid cut-out displacement is classically described, along with a number of technical drawbacks. In a series of six elderly patients with hip fractures in osteoporotic bone, we illustrate catheter-assisted delivery of limited amounts of a new bisphenol-a-glycidyl dimethacrylate (bis-GMA)–based composite into hip compression screw threads, enabling significant increase in insertional torque compared with unaugmented screws. In two patients, unaugmented screws that did not initially purchase were tightened with a minimum torque of 1 N-m after augmenting with bis-GMA–based composite. No screw or femoral head displacement relative to baseline (2 days postoperative) was seen in any patient on serial x-rays taken up to 6 months after surgery. This technique adds approximately 10 minutes to surgery time. Advantages of bis-GMA–based composite over traditional PMMA augmentation include mixing on-demand, the ability to make repeated injections over extended periods in the event of femoral head perforations (in one patient in this series), precise placement of adequately small volumes of material, and a lower exotherm. Potentially, this bis-GMA–based composite may reduce the frequency of cut-out complications by enhancing bone–implant interface. © 2004 Lippincott Williams & Wilkins, Inc.