A Novel Introducer for the Hardinge Cement Restrictor Used in Cemented Total Elbow Arthroplasty

Contemporary cementing techniques aim to improve cement penetration into bone, resulting in increased initial fixation strength, a more enduring micro-interlock fixation and reduced failure by aseptic loosening.¹ Intramedullary plugging is integral to this and in humeral preparation prevents cement migration towards the shoulder, which may hinder future surgery. Several humeral plugs have been described.^2–4 The humeral canal lumen is, however, narrowest distally and insertion of an introducer can compromise this canal. We believe that the Hardinge Cement Restrictor (DePuy UK, Leeds, UK) is in popular use but have found the bulky size of the Hardinge introducer problematic.