PURPOSE: Aseptic loosening of the tibial component remains a limitation to the highly successful procedure of total knee arthroplasty (TKA). Pulsed lavage improves bone cement penetration and interface strength in tibial tray cementation. This study tested whether pressurized cement application with a cement gun can compensate the use of jet lavage for bone surface preparation. METHODS: Tibial components were implanted in six pairs of cadaveric tibiae. On one side, pulsed lavage of the tibial bone was combined with finger packing of bone cement; on the other side, syringe lavage and gun cementing was used. Cement penetration into the bone was determined from computed tomography scans, and Interface strength was determined by pull-out testing. RESULTS: Cement penetration was greater (p = 0.004) and interface strength was higher (p = 0.028) in the pulsed lavage group. CONCLUSION: Pressurization of cement by gun application could not compensate for the omission of pulsed lavage. Thus, pulsed lavage should be considered a crucial factor in TKA to improve implant fixation, which cannot be compensated for by cement application technique.
PURPOSE: Aseptic loosening of the tibial component remains a limitation to the highly successful procedure of total knee arthroplasty (TKA). Pulsed lavage improves bone cement penetration and interface strength in tibial tray cementation. This study tested whether pressurized cement application with a cement gun can compensate the use of jet lavage for bone surface preparation. METHODS: Tibial components were implanted in six pairs of cadaveric tibiae. On one side, pulsed lavage of the tibial bone was combined with finger packing of bone cement; on the other side, syringe lavage and gun cementing was used. Cement penetration into the bone was determined from computed tomography scans, and Interface strength was determined by pull-out testing. RESULTS: Cement penetration was greater (p = 0.004) and interface strength was higher (p = 0.028) in the pulsed lavage group. CONCLUSION: Pressurization of cement by gun application could not compensate for the omission of pulsed lavage. Thus, pulsed lavage should be considered a crucial factor in TKA to improve implant fixation, which cannot be compensated for by cement application technique.
Authors: Claudio Glowalla; Max Ertl; Ulrich Lenze; Igor Lazic; Rainer Burgkart; Jan J Lang; Rudiger VON Eisenhart-Rothe; Florian Pohlig Journal: In Vivo Date: 2022 Mar-Apr Impact factor: 2.155
Authors: Bhava R J Satish; Mohan Thadi; Subbiahgounder Thirumalaisamy; Apsingi Sunil; Praveen L Basanagoudar; Bernard Leo Journal: Arch Bone Jt Surg Date: 2018-09
Authors: Yang Sun; Weibo Jiang; Esther Cory; Jason P Caffrey; Felix H Hsu; Albert C Chen; Jincheng Wang; Robert L Sah; William D Bugbee Journal: PLoS One Date: 2017-05-02 Impact factor: 3.240
Authors: Anders M Refsum; Uy V Nguyen; Jan-Erik Gjertsen; Birgitte Espehaug; Anne M Fenstad; Regina K Lein; Peter Ellison; Paul J Høl; Ove Furnes Journal: Acta Orthop Date: 2019-08-27 Impact factor: 3.717