title: Tibial cleaning method for cemented total knee arthroplasty: An experimental study.
abstract: BACKGROUND
  The survival rate of cemented knee prosthesis depends among other factors on optimal cement-bone contact, nevertheless no standard exists for cementing technique of tibial components. The aim of this study was to determine which tibial surface preparation technique leads to the best bone-cement contact.
  
  
  METHODS
  HUMAN TIBIAL PLATEAU SPECIMENS WERE CLEANED IN FOUR DIFFERENT WAYS BEFORE CEMENTING: a) no cleaning, b) manual syringe irrigation, c) fracture brush cleaning, and d) pulsatile jet-lavage. The specimens were cut into transverse sections and the bone cement contact distance was calculated for every 10 mm and the cement penetration depth was measured. Both values were statistically analyzed (ANOVA).
  
  
  RESULTS
  The longest bone-cement contact (62 mm) was seen after PJL, the shortest (10.6 mm) after no cleaning at all. The deepest cement penetration (4.1 mm) again was seen after PJL, the least (0.7 mm) after no cleaning. Statistically, PJL yielded the longest bone-cement contact and deepest cement penetration.
  
  
  CONCLUSIONS
  The results supports the use of pulsatile jet-lavage before cementing tibial components in knee arthroplasty.
authors.affiliation: Department of Orthopaedics and Traumatology, University Hospital Freiburg, Hugstetter str 55, Freiburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Helwig
authors.forename: Lukas
authors.initials: L
authors.lastname: Konstantinidis
authors.forename: Anja
authors.initials: A
authors.lastname: Hirschmüller
authors.forename: Verena
authors.initials: V
authors.lastname: Miltenberger
authors.forename: Kerstin
authors.initials: K
authors.lastname: Kuminack
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Südkamp
authors.forename: Oliver
authors.initials: O
authors.lastname: Hauschild
keywords: Bone preparation; cemented total knee arthroplasty; cementing technique; pulsatile jet-lavage