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AN EXPERIMENTAL MODEL TO COMPARE TECHNIQUES OF CEMENTING THE TIBIAL COMPONENT IN TOTAL KNEE REPLACEMENT



Abstract

The 4th England and Wales NJR showed that 83% of total knee replacements were cemented (47,626 knees). This study aimed to compare modern techniques of cementation of the proximal tibia in an experimental model against tourniquet-less knee replacement surgery with cancellous bone suction and a cement gun.

A metal box was constructed to approximate the proximal tibia and open cell sawbone simulated the tibia with simulated blood flow and bone suction. Each sample was prepared in an identical fashion except for the cementing technique. The techniques compared were of

  1. Tourniquet,

  2. No tourniquet,

  3. No tourniquet + cancellous bone suction and

  4. No Tourniquet, suction applied + cement gun pressurisation.

Samples were subsequently sectioned, polished and the cemented area measured using a planimeter.

ANOVA testing demonstrated that the techniques were significantly different (p< 0.0001). Bonferroni Comparison demonstrated that the Exeter technique gave significantly better cement penetration for central and lateral measurements (p< 0.0001 and p< 0.0001) compared to all other methods.

The authors believe that our technique of cementation of the proximal tibia offers an easy and reproducible way of getting good quality cementing of the tibial component in total knee replacement and this is borne out by our experimental model.

The abstracts were prepared by Mr D J Bracey, Editorial Secretary. Correspondence should be addressed to him at Royal Cornwall Hospital, Treliske, Cornwall TR1 3LJ, England.