Improving the cementation of the tibial component in knee arthroplasty: a study of four techniques in the cadaver

• Main Authors: Juan Ramón Rodríguez-Collell, Damian Mifsut, Amparo Ruiz-Sauri, Luis Rodríguez-Pino, Eva María González-Soler, Alfonso Amador Valverde-Navarro
• Format: Article
• Language: English
• Published: The British Editorial Society of Bone & Joint Surgery 2021-08-01
• Series: Bone & Joint Research
• Subjects: total knee arthroplasty; cementation techniques; tibial components; bone cement; tibial tray’s; tibial bone; knee arthroplasty; epiphysis; metaphysis; t-test; bone plugs; tourniquets
• Online Access: https://online.boneandjoint.org.uk/doi/epdf/10.1302/2046-3758.108.BJR-2020-0524.R1

Aims: The main objective of this study is to analyze the penetration of bone cement in four different full cementation techniques of the tibial tray. Methods: In order to determine the best tibial tray cementation technique, we applied cement to 40 cryopreserved donor tibiae by four different techniques: 1) double-layer cementation of the tibial component and tibial bone with bone restrictor; 2) metallic cementation of the tibial component without bone restrictor; 3) bone cementation of the tibia with bone restrictor; and 4) superficial bone cementation of the tibia and metallic keel cementation of the tibial component without bone restrictor. We performed CT exams of all 40 subjects, and measured cement layer thickness at both levels of the resected surface of the epiphysis and the endomedular metaphyseal level. Results: At the epiphyseal level, Technique 2 gave the greatest depth compared to the other investigated techniques. At the endomedular metaphyseal level, Technique 1 showed greater cement penetration than the other techniques. Conclusion: The best metaphyseal cementation technique of the tibial component is bone cementation with cement restrictor. Additionally, if full tibial component cementation is to be done, the cement volume used should be about 40 g of cement, and not the usual 20 g.