title: Improving accuracy of total knee component cementation: description of a simple technique.
abstract: BACKGROUND
  Total knee arthroplasty represents a common orthopedic surgical procedure. Achieving proper alignment of its components with the predrilled patellar and tibial peg holes prior to polymerization of the bone cement can be challenging.
  
  
  METHODS
  After establishing the femoral, patellar and tibial bone cuts, the cancellous bone around the tibial keel, as well as the peg holes for the patella and femoral components are marked with methylene blue using a cotton swab stick. If bone cement is then placed onto the cut and marked bone edges, the methylene blue leaches through the bone cement and clearly outlines the tibial keel and predrilled femoral and patellar peg holes. This allows excellent visualization of the bone preparations for each component, ensuring safe and prompt positioning of TKA components while minimizing intraoperative difficulties with component alignment while the cement hardens.
  
  
  CONCLUSIONS
  The presented technical note helps to improve the accuracy and ease of insertion when the components of total knee arthroplasty are impacted to their final position.
authors.affiliation: Department of Orthopaedic Surgery, Denver Health Medical Center, University of Colorado School of Medicine, 777 Bannock Street, Denver, CO 80204, USA. steven.morgan@dhha.org.
authors.forename: William B
authors.initials: WB
authors.lastname: Lutes
authors.forename: Michael A
authors.initials: MA
authors.lastname: Flierl
authors.forename: Michael R
authors.initials: MR
authors.lastname: Dayton
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Morgan