Results of Hip Hemiarthroplasty for Femoral Neck Fracture using High-viscosity Bone Cement Injected with Invented Cement Gun

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Pasawat Lalitwongsa
Napon Wongkamthong


Background: The standard cementing technique for cemented hip arthroplasty requires an injection gun, with high-viscosity bone cement being preferred over low-viscosity cement. A novel gun, the Lampang Cement Gun for High-Viscosity Cement (LCG-HV), was invented based on a caulking gun to accomplish this task, serving as an alternative to the commercial cement gun
Objectives: To investigate the efficacy of the LCG-HV and analyze the unit cost, as well as determine the clinical results of cemented bipolar hip hemiarthroplasty using the LCG-HV in terms of quality of cementation and functional outcome.
Material and methods: The first part of the research involved an experimental study using the LCG-HV to inject Palacos R high-viscosity cement. The injection speed and maximum trigger force were measured, and the unit cost per single usage was calculated. The second part of the research was a retrospective cohort study among 52 patients with femoral neck fractures who underwent cemented bipolar hip hemiarthroplasty at Lampang Hospital from January 2019 to April 2023. This procedure used high-viscosity cement and the LCG-HV. Cementation quality was assessed through radiographic evaluation using the Barrack grading system, and the Harris Hip Score (HHS)was assessed at 6 to 12 months postoperatively.
Results: The mean injection speed of the LCG-HV was 4.1±0.4 g/sec (range 3.5–4.5), and the maximum trigger force was 135±10 kg-force (range 124–145). The unit cost of the LCG-HV was 250 Baht for one-time usage (comprising a direct cost of 225 Baht and an indirect cost of 25 Baht). The mean age of the patients was 81.4±7.9 years (range 63–97), with 47 cases being female (90.4%). The types of femoral prostheses used were the Avenir stem in 38 cases (73.1%), the CPT stem in 11 cases (21.1%), and the Excia stem in 3 cases (5.8%). The cementation quality was mostly
categorized as Barrack grade B (53.8%) and grade A (40.4%). Postoperatively, the mean HHS was 76.8±6.9, with 23 cases (44.2%) classified as having excellent or good levels.
Conclusion: LCG-HV features an injection speed suitable for high-viscosity bone cement and a maximum trigger force at the standard level. Its unit cost is lower than that of a commercial gun. Clinical utilization in bipolar hip hemiarthroplasty has provided satisfactory postoperative results and has been able to achieve optimal quality of cementation.

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How to Cite
Lalitwongsa, P., & Wongkamthong, N. (2024). Results of Hip Hemiarthroplasty for Femoral Neck Fracture using High-viscosity Bone Cement Injected with Invented Cement Gun. Lampang Medical Journal, 44(2), 58–66. Retrieved from
Original Article


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