Method of enhancing interdigitation of bone cement to bone for attachment of prosthesis to bone during arthroplasty

A method of attaching a prosthetic implant to a bone comprising:

• trimming away an articular surface of the bone, leaving a trimmed surface of the bone;
• forming a plurality of holes of depth between two and five millimeters into the trimmed surface of the bone, holes having diameter between one and four millimeters, the holes forming a pattern with hole density between 1 and 6 per square centimeter, and total area of holes is less than one half the surface area of the trimmed surface of the bone;
• the holes being formed by a hole-forming method selected from the group of hole forming methods consisting of:
• placing a punch-plate having a plurality of distinct, parallel sharpened punches, the parallel sharpened punches perpendicular to and extending equally from a first surface of the punch-plate, the first surface being parallel to a strike surface of the punch-plate, on the trimmed surface of the bone, the plurality of sharpened punches in contact with the trimmed surface, using a mallet to strike a strike surface of the punch plate to drive the punches into the trimmed surface thereby forming an array of punched holes in the trimmed surface, and removing the punch plate from the bone;
• placing a template having a plurality of predrilled guidance holes on the trimmed surface of the bone, using a hand drill to drill holes of predetermined depth through the guidance holes of the template into the trimmed surface of the bone, and removing the template from the bone;
• and
• positioning a robotic drilling system over the trimmed surface of the bone, adjusting a drilling pattern of the robotic drilling system according to the trimmed surface of the bone, using the robotic drilling system to drill holes of predetermined depth according to the drilling pattern into the trimmed surface of the bone;
• and
• using a polymethyl methacrylate bone cement to attach the trimmed surface to the prosthetic implant, such that the polymethyl methacrylate bone cement penetrates into the punched holes;
• wherein the bone is selected from the group consisting of the articular surface of a femur, an acetabulum and the articular surface of a glenoid.