Abstract
We evaluated the efficacy of a cement gun to improve the depth of cement penetration in total knee arthroplasty. Ninety-one consecutive patients from two hospitals were recruited for this study. For Group I cement was applied to the tibial baseplate and the proximal tibia with fingers. Group 2 had similar application of cement to the tibial baseplate but cement was pressurized into the proximal tibia using a cement gun.. The knee was kept extended until the cement hardened. Standard post-operative x-rays were reviewed to assess cement penetration into the proximal tibia. The mean cement penetration was 2.1 mm in Group 1 and 3.1 mm in Group 2 and the difference was statistically significant. The use of the cement gun improves cement penetration into the proximal tibia and facilitates early stability of the implant fixation to the bone.
Highlights
We evaluated the efficacy of a cement gun to improve the depth of cement penetration in total knee arthroplasty
When we compare various zones between the 2 groups, cement penetration was significantly better in all zones except for zones 1 and zones 2 in group 2 suggesting a beneficial outcome with the use of a cement gun (P < 0.001) (Figure 4)
The incidence of a radiolucent line occurring in any zone was 87.2 % in Group 1 and 34.1% in Group 2, a statically significant difference (P < 0.001)
Summary
We evaluated the efficacy of a cement gun to improve the depth of cement penetration in total knee arthroplasty. The use of the cement gun improves cement penetration into the proximal tibia and facilitates early stability of the implant fixation to the bone. One commonly used technique is to apply cement to the implant and cut bone surfaces with fingers. The implant is applied and impacted using a mallet 14 Another technique rely on negative pressure in the form of tibia canal suction 15 to improved penetration of the cement into the bone 16. Use of a cement gun is a well established practice in hip arthroplasty , 17-22 and it generally allows for good cement penetration. The aim in this study was to find out if it was possible to improve cement penetration during TKA with the use of cement gun. Components may sink or subside into bone because of loss of local bone density following TKA .7-9 Most surgeons use fully cemented TKA 10
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