On the immediate postoperative radiograph after cemented total hip arthroplasty, the cement mantle around the femoral stem shows small scattered radiolucencies between cement and bone but fills the canal completely with no defects. Using the Barrack grading system, this cementing technique is graded:

• A Grade A
• B Grade D
• C Grade C
• D Grade B ✓

Explanation

The Barrack classification grades femoral cement technique radiographically: grade A is a complete white-out with cement extending beyond soft tissue, grade D shows a full cement mantle with slight radiolucency at the bone-cement interface, grade C shows an incomplete mantle with voids or a deficient cement column below the stem tip, and grade B shows gross cement deficiency with the stem contacting bone. Scattered lucencies with a complete canal fill define grade D.

Reference: Campbell's Operative Orthopaedics, 14th ed.

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Written and medically reviewed by the StethoPrep medical team.