Use of Cement Gun for Fixation of Tibia Component in Total Knee Arthroplasty

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.

The effect of multiple drilling on a sclerotic proximal tibia during total knee arthroplasty

“…In our present study, the number of cases with a multiple drilling procedure using 2.0 mm diameter in the group was 290 and the number of cases using 4.5 mm diameter was 109. Those case numbers in both groups were higher than that of previous similar studies which dealt with cementation technique [5,[7][8][9]24].…”

“…Only one patient demonstrated progressive tibial radiolucencies at 13.1 years' follow-up in this previous study, using a cemented platform with cementless keel fixation. For most orthopedic surgeons, cemented TKAs still have been the most preferred method to promote implant fixation [5,[7][8][9]24]. The strength of our study was that we were able to suggest the simple and effective multiple drilling technique to improve the cement penetration in cemented TKA.…”

“…Pulsatile lavage irrigation with subsequent suction of the bony cut surfaces and cement pressurization with an instrument such as a cement gun has improved the fixation strength of the implants [8,9]. The occurrence rate of implant loosening has decreased following improved cementing techniques.…”