Cementing technique for primary knee arthroplasty: a scoping review

Refsum, Anders Myhre; Nguyen, Uy Viet; Gjertsen, Jan Erik; Fenstad, Anne Marie; Lein, Tor Eiliv; Ellison, Peter; Høl, Paul Johan; Furnes, Ove

doi:10.1080/17453674.2019.1657333

Cited by 26 publications

(17 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After 2010, the UKA gradually became popular, and its main focus was on “follow-up”, “survival analysis”, “risk factors” and other aspects. In 2020, the latest research has shifted from the UKA clinical efficacy analysis to revision surgery, plus hip-knee synergy and patient satisfaction [ 37 ]. Research effort is no longer directed to the role of one single factor, but is multifaceted.…”

Section: Discussionmentioning

confidence: 99%

Global research status and trends of UKA for knee osteoarthritis: a bibliometric analysis

Liu

Zhang

et al. 2020

Arthroplasty

View full text Add to dashboard Cite

Objective As an alternative of knee-protection surgery, unicompartmental knee arthroplasty has been widely used for the treatment of knee osteoarthritis and has achieved good clinical results. However, reports on its data and trend are scanty. This article reviewed current status and trend in the research of UKA, and compared different regions, organizations and authors in terms of their contributions to the field. Methods The literature on UKA ranging from 2009 to 2019 was searched in the “Web of Science” database, and the search results were visually presented by using Excel and VOS-viewer software packages, and the status quo and development trends of relevant studies were analyzed. Results A total of 1264 articles on UKA were identified, of which 330 were the larger studies conducted in the United States. The institution that published most papers was Oxford University, with a total of 109 papers published. MURRAY DW was the largest contributor in this field. The National Institutes of Health was the largest funding agencies of the UKA. Studies could be divided into six clusters in terms of prosthesis design, follow-up investigation, OA etiology, hip-knee association, joint replacement registration, and computer navigation. “Computer-aided navigation” and “gait analysis” promise to be future hot spots in the field of UKA research. Conclusion Global trend analysis suggests that UKA research is gradually deepening and the number of papers has been on the rise. The USA was the largest contributor to this field. More research effort should be directed to “Computer-aided navigation”and “gait analysis”, which might be the popular topics in the UKA field in not very distant future.

show abstract

Section: Discussionmentioning

confidence: 99%

Global research status and trends of UKA for knee osteoarthritis: a bibliometric analysis

Liu

Zhang

et al. 2020

Arthroplasty

View full text Add to dashboard Cite

show abstract

“…Regarding cement application, however, there is some disagreement about the best approach. 11 - 13 Refsum et al 14 showed that in six out of ten cases, cement application was performed with a cement gun, and in four cases by finger-packing technique. The question of cement application to the undersurface of the prosthesis with or without cementation of the stem is still controversial.…”

Section: Introductionmentioning

confidence: 99%

Does tibial design modification improve implant stability for total knee arthroplasty? An experimental cadaver study

Jaeger

Eissler

Schwarze

et al. 2022

Bone & Joint Research

View full text Add to dashboard Cite

Aims One of the main causes of tibial revision surgery for total knee arthroplasty is aseptic loosening. Therefore, stable fixation between the tibial component and the cement, and between the tibial component and the bone, is essential. A factor that could influence the implant stability is the implant design, with its different variations. In an existing implant system, the tibial component was modified by adding cement pockets. The aim of this experimental in vitro study was to investigate whether additional cement pockets on the underside of the tibial component could improve implant stability. The relative motion between implant and bone, the maximum pull-out force, the tibial cement mantle, and a possible path from the bone marrow to the metal-cement interface were determined. Methods A tibial component with (group S: Attune S+) and without (group A: Attune) additional cement pockets was implanted in 15 fresh-frozen human leg pairs. The relative motion was determined under dynamic loading (extension-flexion 20° to 50°, load-level 1,200 to 2,100 N) with subsequent determination of the maximum pull-out force. In addition, the cement mantle was analyzed radiologically for possible defects, the tibia base cement adhesion, and preoperative bone mineral density (BMD). Results The BMD showed no statistically significant difference between both groups. Group A showed for all load levels significantly higher maximum relative motion compared to group S for 20° and 50° flexion. Group S improved the maximum failure load significantly compared to group A without additional cement pockets. Group S showed a significantly increased cement adhesion compared to group A. The cement penetration and cement mantle defect analysis showed no significant differences between both groups. Conclusion From a biomechanical point of view, the additional cement pockets of the component have improved the fixation performance of the implant. Cite this article: Bone Joint Res 2022;11(4):229–238.

show abstract

“…To minimize the risk of aseptic loosening, which usually manifests itself through persistent pain [ 8 ], and achieve high long-term survival rates of implants, the cementing technique has been improved and standardized in recent decades. In TKA, standard techniques include employment of high-pressure pulsatile saline lavage irrigation as well as drilling holes into the sclerotic tibia, drying the bone and applying vacuum-mixed cement to both implant and bone [ 9 ]. Third-generation cementing techniques in THA involve aggressive rasping, using high-pressure pulsatile saline lavage irrigation, using a distal cement restrictor, applying vacuum-mixed cement using a retrograde technique into the femur via a cement gun, pressurizing the cement and inserting the stem with a distal centralizer [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Pulsatile Lavage Systems with High Impact Pressure and High Flow Produce Cleaner Cancellous Bone Prior to Cementation in Cemented Arthroplasty

Knappe

Bitsch²,

Schonhoff

et al. 2021

JCM

View full text Add to dashboard Cite

In cemented joint arthroplasty, state-of-the-art cementing techniques include high-pressure pulsatile saline lavage prior to cementation. Even with its outstanding importance in cementation, there are surprisingly few studies regarding the physical parameters that define pulsatile lavage systems. To investigate the parameters of impact pressure, flow rate, frequency and the cleaning effect in cancellous bone, we established a standardized laboratory model. Standardized fat-filled carbon foam specimens representing human cancellous bone were cleaned with three different high-pressure pulsatile lavage systems. Via CT scans before and after cleaning, the cleaning effect was evaluated. All systems showed a cleaning depth of at least 3.0 mm and therefore can be generally recommended to clean cancellous bone in cemented joint arthroplasty. When comparing the three lavage systems, the study showed significant differences regarding cleaning depths and volume, with one system being superior to its peer systems. Regarding the physical parameters, high impact pressure in combination with high flow rate and longer distance to the flushed object seems to be the best combination to improve the cleaning of cancellous bone and therefore increase the chances of a deeper cement penetration that is required in cemented joint arthroplasty. In summary, this study provides the first standardized comparison of different lavage systems and thus gives initial guidance on how to optimally prepare cancellous bone for cemented joint arthroplasty.

show abstract

Cementing technique for primary knee arthroplasty: a scoping review

Cited by 26 publications

References 67 publications

Global research status and trends of UKA for knee osteoarthritis: a bibliometric analysis

Global research status and trends of UKA for knee osteoarthritis: a bibliometric analysis

Does tibial design modification improve implant stability for total knee arthroplasty? An experimental cadaver study

Pulsatile Lavage Systems with High Impact Pressure and High Flow Produce Cleaner Cancellous Bone Prior to Cementation in Cemented Arthroplasty

Contact Info

Product

Resources

About