Correlation of cementation technique with bone stock preservation in total knee arthroplasty

Abstract

Background: The purpose of this study was to detect the change in size of the trial plastic insert needed to achieve maximal coronal plane stability in total knee arthroplasty (TKA) with the knee in full extension before and after cementation of the final components. Methods: In 64 consecutive primary total knee arthroplasties, the sizes of the plastic trial inserts fulfilling the above criteria were recorded before and the after cementation of the final components using a definite cementation technique that ensures proper seating of the components in a fully extended knee. Results: A statistically significant (P<0.05) increase of the definite polyethylene insert size with a mean difference of 2 mm was found. There was no statistically significant difference in the result between men and women, between fixed and mobile bearing designs, or between the two implant systems used in this study. Conclusions: We concluded that proper seating of the components with our cementation technique would leave an extra space of 2 mm to the residual extension gap. In view of this result, the knee arthroplasty surgeon could save 2 mm of unnecessary proximal tibial resection and preserve the extra bone stock for future revision surgery.