Bhava R J Satish1,2,3,4,5,6, Mohan Thadi1,2,3,4,5,6, Subbiahgounder Thirumalaisamy1,2,3,4,5,6, Apsingi Sunil1,2,3,4,5,6, Praveen L Basanagoudar1,2,3,4,5,6, Bernard Leo1,2,3,4,5,6. 1. Research performed at BRJ Orthocentre and MAK Hospital, Coimbatore, India. 2. BRJ Orthocentre and MAK Hospital, Eru Company Stop, Mettupalayam Road, Coimbatore, India. 3. Amrita Institute of Medical Sciences, Ponekkara, Edappally, Kochi, Kerala, India. 4. Kovai Medical Centre Hospital, Avanashi road, Peelamedu, Coimbatore, Tamil Nadu, India. 5. Maxcure Hospitals, Hitech City, Madhapur, Hyderabad, Telangana, India. 6. Sagar Hospital Banashankari, DSI Institutions kumarasamy layout, Bangalore, India.
Abstract
BACKGROUND: No scientific evidence exists regarding the amount of bone cement used and discarded in primary cemented Total knee arthroplasty (TKA). The aim of this study was to identify the exact amount of bone cement utilized for component fixation in primary TKA. METHODS: In a prospective study carried out at five centers, 133 primary cemented TKAs were performed. One pack of 40g Palacos bone cement (PBC 40) was hand mixed and digitally applied during the surgery. After fixation of the TKA components, the remaining bone cement was methodically collected and weighed on a digital weighing scale. The actual quantity of cement utilized for component fixation was calculated. RESULTS: On an average, 22.1 g of bone cement was utilized per joint, which accounted to 39 % of 57 g, the solidified dry weight of PBC 40. Among 133 knees, the cement usage was 20 % to 50% in 109 knees, more than 50% in 20 knees and less than 20% in 4 knees. Knees which received larger sized femoral implant required more cement compared to medium and small sizes. Knees which had pulse lavage had more cement utilization compared to knees which had simple syringe lavage before implantation. CONCLUSION: Large quantity of bone cement was handled than actual requirements in primary TKA when a standard 40g pack was used with the digital application technique, resulting in sizeable discard of bone cement. Customizing cement pack according to the implant size can potentially avoid this cement wastage. Future research is required to study the utility and economic impact of smaller packs (20 g or 30 g) of bone cement in primary TKA.
BACKGROUND: No scientific evidence exists regarding the amount of bone cement used and discarded in primary cemented Total knee arthroplasty (TKA). The aim of this study was to identify the exact amount of bone cement utilized for component fixation in primary TKA. METHODS: In a prospective study carried out at five centers, 133 primary cemented TKAs were performed. One pack of 40g Palacos bone cement (PBC 40) was hand mixed and digitally applied during the surgery. After fixation of the TKA components, the remaining bone cement was methodically collected and weighed on a digital weighing scale. The actual quantity of cement utilized for component fixation was calculated. RESULTS: On an average, 22.1 g of bone cement was utilized per joint, which accounted to 39 % of 57 g, the solidified dry weight of PBC 40. Among 133 knees, the cement usage was 20 % to 50% in 109 knees, more than 50% in 20 knees and less than 20% in 4 knees. Knees which received larger sized femoral implant required more cement compared to medium and small sizes. Knees which had pulse lavage had more cement utilization compared to knees which had simple syringe lavage before implantation. CONCLUSION: Large quantity of bone cement was handled than actual requirements in primary TKA when a standard 40g pack was used with the digital application technique, resulting in sizeable discard of bone cement. Customizing cement pack according to the implant size can potentially avoid this cement wastage. Future research is required to study the utility and economic impact of smaller packs (20 g or 30 g) of bone cement in primary TKA.
Entities:
Keywords:
Bone cement quantity; Cement utility; Primary knee arthroplasty
Authors: S M Hauptmann; P Weber; C Glaser; C Birkenmaier; V Jansson; P E Müller Journal: Knee Surg Sports Traumatol Arthrosc Date: 2008-05-31 Impact factor: 4.342
Authors: Pedro Hinarejos; Albert Fontanellas; Joan Leal-Blanquet; Juan Sánchez-Soler; Raul Torres-Claramunt; Juan Carlos Monllau Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-03-14 Impact factor: 4.342