Abstract
BackgroundIn cemented primary total knee arthroplasty (TKA), aseptic loosening remains a major cause for failure. Cementing techniques and characteristics of a chosen cement play a key role for good fixation and implant survival. A pastry bone cement was developed to facilitate the cement preparation and to rule out most of preparation-associated application errors. The pastry bone cement was compared to a conventional polymethyl methacrylate cement in a TKA setting.MethodsStandardized implantations of total knee endoprostheses were performed in bilateral knee cadavers to investigate handling properties, variables of cement application, working time, and temperature development. Mechanical aspects and cementation quality were assessed by pull-out trials and microscopic interface analysis.ResultsBoth cements expressed similar characteristics during preparation and application, only the curing time of the pastry cement was about 3 min longer and the temperature peak was lower. Fractures of the conventional cement specimens differed from the pastry cement specimens in the tibial part, while no differences were found in the femoral part. Penetration depth of the pastry cement was similar (tibia) or deeper (femur) compared to the conventional cement.ConclusionsThe pastry cement facilitates the feasibility of cemented TKA. The pre-clinical tests indicate that the pastry bone cement fulfills the requirements for bone cement in the field of knee arthroplasty. A clinical trial is needed to further investigate the approach and ensure patient safety.
Highlights
In cemented primary total knee arthroplasty (TKA), aseptic loosening remains a major cause for failure
Even though the use of uncemented implants has increased in recent years, bone cement remains the predominant technique used in total knee arthroplasty (TKA)
Factual investigation Sixteen knee joints from eight prepared cadavers were used for the evaluation of TKA
Summary
In cemented primary total knee arthroplasty (TKA), aseptic loosening remains a major cause for failure. Cementing techniques and characteristics of a chosen cement play a key role for good fixation and implant survival. A pastry bone cement was developed to facilitate the cement preparation and to rule out most of preparation-associated application errors. The pastry bone cement was compared to a conventional polymethyl methacrylate cement in a TKA setting. In the field of joint replacement surgery, cemented and cement-less (“press-fit”) techniques are used for implant fixation [1]. Even though the use of uncemented implants has increased in recent years, bone cement remains the predominant technique used in total knee arthroplasty (TKA). The developments include vast improvements in bone bed preparation, cement preparation, and cement delivery [14]
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