Does use of a “rim cutter” improve quality of cementation of the acetabular component of cemented exeter total hip arthroplasty?

A randomized controlled trial was performed to assess the effect of a rim cutter device on cement mantles in modern elective total hip replacement using a flanged acetabular component. Forty patients were randomized to a rim cutter (21) or control (19) group. A statistically significant improvement in cement penetration was demonstrated in zone 1 (10.1 versus 8.6mm (p=0.023)), and in cement mantle thickness in zones 2 and 3 (7.8mm and 6.7mm versus 5.7 and 5.4mm (p<0.001 and p=0.017); with a reduced incidence of bottoming out of the socket (1/21 versus 8/19 (p=0.007). Cement mantle thicknesses greater than 8mm were achieved more consistently in the rim cutter group (30% versus 2%). This technique improves cement penetration and mantle thickness in a reliable manner.