Comparison of different cement application techniques for tibial component fixation in TKA

• Published in: International orthopaedics 2015-01, Vol.39 (1), p.47-54
• Main Authors: Schlegel, Ulf J., Bishop, Nicholas E., Püschel, Klaus, Morlock, Michael M., Nagel, Katrin
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - methods; Bone Density; Cementation - methods; Female; Humans; Image Processing, Computer-Assisted; Male; Medicine; Medicine & Public Health; Motion; Original Paper; Orthopedics; Prosthesis Failure; Therapeutic Irrigation - methods; Tibia - surgery
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-014-2468-x

Purpose Aseptic loosening of the tibial component remains a major cause for revision surgery in total knee arthroplasty (TKA). A stable initial fixation of the tibial implant has been suggested to reduce micromotion of the implant and could be decisive regarding its long-term performance. Different techniques for applying cement to the tibial surface have been described in the literature, with controversial results. No guidelines in favour of any particular approach are available. Methods In this study, we compared three commonly used cementing techniques (layered application, stem cementation, cement gun) with surface-only fingerpacking cementation following pulsed lavage (paired human tibiae, four groups, n  = 24). Specimens underwent computed tomography scanning for three-dimensional analysis of cement penetration and mechanical testing for assessing interface strength. Results Bone cement penetration decreased with increasing bone mineral density (BMD) ( R 2  = 0.18, p  = 0.023), while interface strength increased with BMD ( R 2  = 0.56, p