CEMENTING TECHNIQUES IN KNEE SURGERY (CETIKS): A UK EXPERT CONSENSUS STUDY

Abstract

AbstractIntroductionAseptic loosening is the most common cause of failure following cemented total knee arthroplasty (TKA) and this has been linked to poor cementation technique. We aimed to develop a consensus on the optimal technique for component cementation in TKA.MethodologyA UK based, three round, online modified Delphi Expert Consensus Study was completed focussing on cementation technique in TKA. Experts were identified as having a minimum of 5 years Consultant experience in the NHS and fulfilling any one of the following three criteria:· A ‘high volume’ knee arthroplasty practice (>150 TKA per annum) as identified from the National joint registry (NJR).· A senior author of at least 5 peer reviewed articles related to TKA in the previous 5 years· A named trainer for a post CCT fellowship in TKA.ResultsEighty-one experts (Round 1) and eighty experts (Round 2 and 3) completed the Delphi Study. Four domains with a total of twenty-four statements were identified. 100% consensus was reached within the cement preparation, pressurisation, and cement curing domains. 90% consensus was reached within the cement application domain. Consensus was not reached with only one statement regarding the handling of cement during initial application to the tibial and/or femoral bone surfacesConclusionThe CeTIKS expert consensus study presents comprehensive recommendations on the optimal technique for component cementation in TKA. Expert opinion has a place in the hierarchy of evidence and until better evidence is available these recommendations should be considered when cementing a TKA.