Tariq A Kwaees1,2, Rohit Singhal1,2, Denise Eygendaal3,4, Charalambos P Charalambous2,5. 1. Health Education Northwest, Summers Road, Liverpool, Mersey, L3 4BL, UK. 2. Department of Orthopaedics, Blackpool Victoria Hospital, Whinney Heys Road Blackpool, Lancashire, FY3 8NR, UK. 3. Department of Orthopedic Surgery, Amphia Hospital, Pasteurlaan 9, 4901DH Oosterhout, the Netherlands. 4. University of Amsterdam, 1012 WX, Amsterdam, the Netherlands. 5. School of Medicine, University of Central Lancashire, Fylde Road, Preston, Lancashire, PR1 2HE, UK.
Abstract
BACKGROUND: Modern cementation techniques have markedly improved survivorship in lower limb arthroplasty, which have been heavily researched in the hip and knee but less so for upper limb procedures. Aseptic loosening is a leading cause of failure in total elbow arthroplasty (TEA) which could be related to the quality of cementation. The aim of this study was to investigate the cementation techniques used for TEA among practicing elbow surgeons. METHODS: An electronic questionnaire was emailed to members of the British elbow and shoulder society (BESS) and PubMed identified experts. Questions focused on the type of prosthesis, operative rates for elective and trauma cases, nature of cement used, canal preparation and cement insertion. Opinions regarding satisfaction with current techniques and mantle quality were also collected. RESULTS: A total of 26 surgeons completed the questionnaire. The Coonrad-Moorey was the most popular device amongst respondents. Most cemented both components, used antibiotic loaded cement, washed the canal with saline and inserted the cement retrograde. There was wide variation in cementation techniques used for the humerus and ulna, particularly regarding cement preparation, insertion, and use of a restrictor and pressurisation. CONCLUSION: Modern cementation techniques are not being utilised in TEA which could be contributing to implant loosening rates and longevity.
BACKGROUND: Modern cementation techniques have markedly improved survivorship in lower limb arthroplasty, which have been heavily researched in the hip and knee but less so for upper limb procedures. Aseptic loosening is a leading cause of failure in total elbow arthroplasty (TEA) which could be related to the quality of cementation. The aim of this study was to investigate the cementation techniques used for TEA among practicing elbow surgeons. METHODS: An electronic questionnaire was emailed to members of the British elbow and shoulder society (BESS) and PubMed identified experts. Questions focused on the type of prosthesis, operative rates for elective and trauma cases, nature of cement used, canal preparation and cement insertion. Opinions regarding satisfaction with current techniques and mantle quality were also collected. RESULTS: A total of 26 surgeons completed the questionnaire. The Coonrad-Moorey was the most popular device amongst respondents. Most cemented both components, used antibiotic loaded cement, washed the canal with saline and inserted the cement retrograde. There was wide variation in cementation techniques used for the humerus and ulna, particularly regarding cement preparation, insertion, and use of a restrictor and pressurisation. CONCLUSION: Modern cementation techniques are not being utilised in TEA which could be contributing to implant loosening rates and longevity.
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