Vital staining of bone in stable, retrieved femoral surface replacement prostheses: A microscopic study of undecalcified ground sections

We used vital staining with tetracycline to detect viability of bone at the bone–cement interface in 11 stable ICLH femoral surface replacement prostheses that were retrieved at revision surgery for acetabular loosening. The resected femoral heads were processed for undecalcified ground sections with the prostheses in situ. All sections showed direct bone-to-cement contacts. Bone in direct contact with or close to the cement sometimes showed an abnormal staining, indicating that the bone was not fully mineralized. Areas with fluorescence were observed within all femoral heads but never in direct bone-to-cement contact. From this study, we conclude that the mechanical stability of these cemented femoral surface replacement prostheses depends mainly on the original bone present at the time of primary operation.