Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Jonas Lies Vei 87, 5021, Bergen, Norway.
Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.
BMC Musculoskelet Disord. 2023 Nov 18;24(1):900. doi: 10.1186/s12891-023-07040-2.
Cementing technique in total knee arthroplasty (TKA) may influence implant survival. There is limited knowledge about the results with clinically used techniques. The aim of this study was to investigate cementing techniques for TKA in Norwegian hospitals, to compare widely used techniques to recommendations from the literature, and to investigate variation within hospitals.
A questionnaire requesting information about cementing techniques were distributed to all Norwegian orthopedic surgeons performing TKAs regularly in 2020. Data was analyzed using descriptive statistical methods.
We acquired 121 responses out of 257 surgeons. They were from 45 out of 56 hospitals, and at least half of the TKA surgeons from 20 hospitals, constituting 79 surgeons. All responders used pulsatile lavage. Cement application to both the tibial plateau and stem (full cementation) was practiced by 61%. Application of cement to both implant and bone was done by 70% of surgeons. Techniques to improve cement penetration were used by 86%. Only 35% of surgeons aimed to get a cement mantle thickness between 3-5 mm. Flexing the knee joint to remove excess cement was done by 82%. We found that in 55% of 20 hospitals the surgeons did not agree on the use of common guidelines in their ward.
The majority of the responders used recommended techniques from the literature when cementing TKA. At more than half of the eligible hospitals, surgeons disagreed about their hospitals' use of common guidelines. Focusing on developing evidence-based guidelines would be beneficial for TKA-quality.
全膝关节置换术（TKA）中的黏合技术可能会影响植入物的存活率。对于临床应用技术的结果，我们的了解有限。本研究旨在调查挪威医院 TKA 的黏合技术，比较广泛使用的技术与文献中的推荐方法，并调查医院内的差异。
2020 年，我们向所有经常行 TKA 的挪威骨科医生发放了一份关于黏合技术的问卷。使用描述性统计方法分析数据。
我们从 257 名外科医生中获得了 121 份回复。这些回复来自 56 家医院中的 45 家，至少有 20 家医院的一半 TKA 外科医生，共计 79 名外科医生。所有回复者都使用脉动冲洗。61%的医生同时对胫骨平台和柄进行黏合（完全黏合）。70%的医生同时对植入物和骨骼进行黏合。86%的医生使用了技术来提高黏合剂的渗透性。只有 35%的医生希望获得 3-5 毫米厚的黏合剂覆盖层。82%的医生会弯曲膝关节以去除多余的黏合剂。我们发现，在 20 家医院中的 55%，医生不同意在其病房使用共同的指南。
大多数回复者在黏合 TKA 时使用了文献中推荐的技术。在一半以上的合格医院中，外科医生不同意其医院使用共同的指南。专注于制定基于证据的指南将有益于 TKA 质量。
