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It should be noted that the target population in all cases is an elderly Spanish population, a population of short stature with curved femurs and poor bone quality; these characteristics make perforation and intraoperative fractures much more likely. However, in our two patients there were no cortical perforations. The mean time for plug removal was 22 minutes. CONCLUSIóN The use of customised guides for cement plug removal during cemented hip and knee arthroplasty replacement is safe and effective. A new technique for the removal o