The Journal of Arthroplasty
Volume 24, Issue 3 , Pages 461-467, April 2009

The Effect of Cement Gun and Cement Syringe Use on the Tibial Cement Mantle in Total Knee Arthroplasty

  • Michael J. Lutz, MBBS

      Affiliations

    • Orthopaedic Department, Royal Brisbane Hospital, Herston, Queensland, Australia
    • Corresponding Author InformationReprint requests: Michael Lutz, MBBS, C/-Orthopaedic Department, Royal Brisbane Hospital, Herston QLD 4029, Australia
  • ,
  • Paul F. Pincus, FRACS(Orth)

      Affiliations

    • Orthopaedic Department, Royal Brisbane Hospital, Herston, Queensland, Australia
  • ,
  • Sarah L. Whitehouse, PhD

      Affiliations

    • Orthopaedic Research Unit, Queensland University of Technology, Prince Charles Hospital, Queensland, Australia
  • ,
  • Brett R. Halliday, FRACS(Orth)

      Affiliations

    • Orthopaedic Department, Royal Brisbane Hospital, Herston, Queensland, Australia

Received 10 April 2007; accepted 25 October 2007. published online 03 April 2008.

Abstract 

Evidence suggests that a thicker cement mantle improves fixation strength and resistance to tensile and shear forces in the tibial component of total knee arthroplasty. A low proportion of orthopaedic surgeons currently use techniques to improve cement penetration in the tibial plateau. We demonstrate that the use of a pressurized cement gun or cement syringe provides a highly statistically significant difference (P < .001) to the depth of the tibial cement mantle and reduction in radiolucent lines when compared to cement applied by hand. This ensures a thicker cement mantle and may reduce the possibility of early failure by improving the strength of fixation and the resistance to tensile and shear forces. There is no statistical difference in the cement mantle produced by the cement syringe and the cement gun.

Key words: total knee arthroplasty, cement gun, cement syringe, cement mantle, radiolucent lines, cement

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 No benefits or funds were received in support of the study.

 Level of evidence: Therapeutic study. Level II (prospective cohort study – patients treated one way compared with a group of patients treated another way at the same institution).

PII: S0883-5403(07)00633-X

doi:10.1016/j.arth.2007.10.028

The Journal of Arthroplasty
Volume 24, Issue 3 , Pages 461-467, April 2009