referring to fig1 and 2 , an exemplary implant 1 is depicted as a femoral hip implant cemented into a human femur 2 . the implant is secured in the femur by a layer 3 of acrylic bone cement which grips the implant due to interdigitation with micro and macro surface features along the interface , or bond line , which exists between the cement and implant . the implant may be loosened according to the present invention by pressurizing fluid at the interface . the fluid pressure stretches the cement enough to relieve its grip on the implant . the cement layer is also vulnerable to fracture and separation due to the fluid pressure . such separation would likely occur at regions of minimum cross sectional thickness . this method and apparatus can be applied to any suitable implant including femoral and acetabular hip implants , femoral and tibial knee implants , shoulder implants , and elbow implants . it may also be employed with any fixing material including plastic bone cements , plasters , and other luting agents . fluid access to the interface may be provided by creating an access port 4 through the cement layer , such as by drilling . drilling may be aided by a drill guide 5 , as shown in fig1 which attaches to the implant and directs the drill to an appropriate region 6 of the interface . likewise , a port could be made in the implant . fluid access may also be provided by holes or channels already existing in the cement or implant . such an access port could be part of the implant when it is sold . fluid is then supplied to the interface . any fluid may be used , however , the fluid is preferably an incompressible liquid such as saline . it is also preferable that the fluid is introduced so as to eliminate air from the port . this can be accomplished by injecting fluid into the port from the bottom using a hypodermic needle . next the port is sealed with a pressure fitting 7 . any fitting that will form a seal with the port may be used . suitable fittings include a threaded fitting , a tapered press fitting , and a cemented fitting . an alternate fitting 8 may include a portion 9 to extend substantially to the bottom of the port to improve the seal or to extend through a portion of bone . the fitting should be well sealed to the port . during pressurization the fitting will be subject to a separation force . for example , a fixing material such as polymethly - methacrylate ( pmma ) bone cement has a tensile strength of approximately 8000 psi . if a port 0 . 040 inches in diameter is used , then a separation force of ten pounds would be exerted on the fitting at 8000 psi . the fitting is connected to a pressurizing device such as a cylinder 10 having a piston 11 advanced by a screw 12 . preferably the system includes a pressure gauge 13 for monitoring the fluid pressure . a system as described above and that is well sealed to prevent leaks is inherently safe as explained in the following description of its operation . the screw is turned to advance the piston which forces fluid into the port and thereby increases the fluid pressure at the interface . when the pressure reaches a critical value the cement will separate from the implant or the cement will fracture or both . as this occurs , the fluid pressure will decrease dramatically so that a high pressure fluid can not be injected into the bone . furthermore , only a small volume of fluid is necessary . the piston can be advanced again . if the crack or separation is only partial , the pressure will build rapidly again and the cycle will repeat . if the crack or separation is complete then the pressure will not build and the implant can be removed or pressure can be applied to another region of the interface . while a piston advanced by a screw has been described , any means for pressurizing the fluid may be used including various manual and powered pumps or pneumatically charged chambers . in the case of a device that can continue to supply pressure it is desirable to include means to monitor the pressure and suspend the supply when a crack or separation is detected . mechanical energy in addition to the fluid pressure may be advantageously applied to the implant . striking , pulling , or vibrating the implant prior to , in conjunction with , or after supplying fluid pressure to the implant may aid in loosening the implant according to this method . while the foregoing has described an exemplary preferred embodiment of the present invention , it will be understood by those skilled in the art that modifications can be made without departing from the spirit and scope of the invention defined by the appended claims .
an implant being securely fixed in a bone by a layer of plastic cement is removed by supplying a pressurized fluid to the interface between the cement and the implant .