Table 3.

Modern cementing technique – 4th generation (3).

Item/instrument/implant	Note
Cement restrictor	Absorbable or non-absorbable
Cooling at 4°C	>24 h (follow instructions for use)
Vacuum mixing	Follow working phases
Brush	Single-use item can also be used with machines
Pulsatile lavage (with brush attachment)	Warmed without additives
Compresses	Watch out for debris
Adrenaline compresses	In Anglo-American literature
Cement gun	Retrograde filling (‘bottom to top’)
Pressurizer	End of marrow space filling
Centralizer	Not for line-to-line technique, e.g. ‘Müller straight stem’
	Not for very narrow marrow spaces <10 mm