Howie Cole, McCrosson Matthew, Padgett Anthony M, Sanchez Thomas, McGwin Gerald, Naranje Sameer
Department of Orthopaedic Surgery, University of Alabama at Birmingham, 1313th Street S, Ste 226, Birmingham, AL, 35205, USA.
Department of Epidemiology, University of Alabama at Birmingham School of Public Health, 1720 University Blvd, Ste 609, Birmingham, AL, 35205, USA.
Arch Orthop Trauma Surg. 2024 Jan;144(1):15-21. doi: 10.1007/s00402-023-05017-3. Epub 2023 Aug 9.
New bone cement products have been developed attempting to shorten their setting time and thus cut down time in the operating room. This study determines whether faster-setting bone cement shortens time in the operating room, and whether the quantity used compromises postoperative TKA outcomes. Additionally, this study looks at cost analyses of the quantity of bone cement used in TKA procedures.
One-hundred and sixty patients at a single institution with primary TKA surgeries between January 2019 and December 2021, and a clinic follow-up of at least one year, were identified. Five cement products used in this time period were identified and categorized by fast- or slow-setting products if their set times were marketed below or above six minutes, respectively.
Estimated blood loss was higher in patients receiving fast-setting cements (160.0 vs 126.4 mL; p = 0.0009); however, operative time showed no difference between the cohorts (88.2 vs 89.2 min; p = 0.99). Fewer bags of cement were used for the fast cohort (1.3 vs 1.8 bags; p < 0.0001). The fast group was significantly cheaper on average per patient only when comparing between antibiotic bone cements (p = 0.007). No differences were found in postoperative outcomes between the two groups.
No differences were found in operative times between the fast and slow cemented groups. Fewer bags of faster-setting cement only proved cost saving relative to other antibiotic bone cements studied. Nonetheless, decreased usage of fast cement did not result in any different postoperative outcomes compared to slow cements.
III.
新型骨水泥产品已被研发出来，试图缩短其凝固时间，从而减少手术室中的时间。本研究旨在确定凝固速度更快的骨水泥是否能缩短手术室时间，以及使用量是否会影响全膝关节置换术（TKA）的术后效果。此外，本研究还对TKA手术中使用的骨水泥量进行了成本分析。
确定了一家机构在2019年1月至2021年12月期间进行初次TKA手术且临床随访至少一年的160例患者。确定了该时间段内使用的五种骨水泥产品，并根据其凝固时间分别归类为快凝或慢凝产品，若其凝固时间在市场宣传中低于或高于6分钟。
接受快凝骨水泥的患者估计失血量更高（160.0对126.4 mL；p = 0.0009）；然而，两组患者的手术时间无差异（88.2对89.2分钟；p = 0.99）。快凝组使用的骨水泥袋数更少（1.3对1.8袋；p < 0.0001）。仅在比较抗生素骨水泥时，快凝组平均每位患者的费用显著更低（p = 0.007）。两组术后效果无差异。
快凝和慢凝骨水泥组的手术时间无差异。与其他研究的抗生素骨水泥相比，使用更少袋数的快凝骨水泥仅证明具有成本效益。尽管如此，与慢凝骨水泥相比，减少快凝骨水泥的使用量并未导致任何不同的术后效果。
III级
