Effect of hand packing versus cement gun pressurization on cement mantle in total knee arthroplasty.
BACKGROUND
Gun pressurization in total knee arthroplasty (TKA) may result in better cement penetration than hand packing, leading to fewer tibial plate failures. We compared cement intrusion characteristics between vacuum mixing and gun pressurization versus hand mixing and packing in the proximal tibia among patients undergoing TKA.


METHODS
We analyzed 6-week radiographs from 77 consecutive patients for cement area and zone-specific intrusion using computer-assisted image analysis.


RESULTS
Penetration into tibial anteroposterior zones 1-6 was not significantly different between the techniques. Intrusion depths in anteroposterior zone 7 and lateral zone 2 were significantly increased with gun pressurization, but this increase was associated with significantly longer operating room and tourniquet times.


CONCLUSIONS
We identified no obvious advantage of vacuum mixing with gun pressurization, suggesting that continued use of the hand-packing technique may be warranted. Additional long-term failure studies must be completed to compare these techniques.
Kopec
Michael
M
Division of Orthopedics and Rehabilitation, Southern Illinois University School of Medicine, Springfield, Ill. 62794-9679, USA.
Milbrandt
Joseph C
JC
Duellman
Todd
T
Mangan
Doug
D
Allan
D Gordon
DG
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D001843:Bone Cements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*
D001843:Bone Cements