Table 7.

Grading of the femoral cement mantle according to Barrack et al. (45).

Grade	Description	Note
A	Complete filling of the medullary canal; no discernible boundary between bone and cement.	‘White out’
B	Stable cement mantle; thin boundary layer between bone and cement	‘Slight radiolucency’ (<50%)
C
C1	Visible boundary zone; small defects (voids) in the cement mantle; incomplete cement mantle.	‘Radiolucency incomplete’ (>50%)
C2	Localized thin cement mantle (<1 mm), defects, direct metal contact; endostal.
D	Radiographically visible boundary layer in both planes; incomplete or interrupted cement mantle; large defects (voids).	‘Radiolucency complete’ (=100%); ‘incomplete coverage of the stem’