Does the subchondral plate help or hinder cemented acetabular cup integration?

What is it about?

The integration of an component of a joint replacement is essential for long term survival of the component. This study looks at how the mechanics of the acetabulum are affected by removing all the subchondral plate (this allowing good interdigitation of the bone cement into the cancellous/trabecular bone) rather than retaining the plate (which potentially could increase the stiffness and strength of the implant-cement-bone system). The conclusions are that the changes in the mechanical behaviour are limited, but that the removal of the plate and addition of anchorage holes increases the long term stability of the implant. Thus "it seems advisable to remove the SCBP wherever possible combined with anchoring drill holes in denser areas in the acetabulum to optimise the long term outcome of the cemented cup."

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