Okuno Yu, Nagira Keita, Ishida Koji, Kanaya Haruhisa, Hayashi Ikuta, Enokida Makoto, Nagashima Hideki
Department of Orthopedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, Tottori, 683-8504, Japan.
Knee Surg Relat Res. 2024 Sep 20;36(1):28. doi: 10.1186/s43019-024-00232-7.
This study aimed to investigate the differences in cement penetration between cementing techniques in total knee arthroplasty (TKA).
We retrospectively evaluated knee undergone TKA at our hospital for both preoperative and postoperative computed tomographic (CT) evaluations. Cementing was performed with hand mixing and hand packing (HM group) and with vacuum mixing and cement gun use (VM group). We measured the area under the tibial baseplate (sclerotic and nonsclerotic sides) and compared the mean and maximum depths of cement penetration at each area.
Of the 44 knees evaluated, 20 and 24 knees were in the HM and VM groups, respectively. At the center of the sclerotic side, the mean penetration depths (2.0 ± 0.7 and 2.5 ± 0.7 mm, p = 0.02) and the maximum penetration depths (4.0 ± 0.9 and 5.0 ± 1.6 mm, p = 0.02) were significantly deeper in the VM group than in the HM group. The correlation between preoperative Hounsfield unit values and mean penetration were r = -0.617 (p < 0.01) and -0.373 (p = 0.01) in the HM and VM groups, respectively.
The cementing technique of vacuum mixing and using a cement gun allowed for deeper cement penetration compared with the hand mixing and hand packing technique, even in bone sclerotic sites.
本研究旨在调查全膝关节置换术(TKA)中不同骨水泥固定技术在骨水泥渗透方面的差异。
我们回顾性评估了在我院接受TKA手术的膝关节患者术前和术后的计算机断层扫描(CT)结果。骨水泥固定采用手工搅拌和手工填充(HM组)以及真空搅拌和使用骨水泥枪(VM组)两种方式。我们测量了胫骨基板下方区域(硬化侧和非硬化侧),并比较了每个区域骨水泥渗透的平均深度和最大深度。
在评估的44个膝关节中,HM组和VM组分别有20个和24个膝关节。在硬化侧中心,VM组的平均渗透深度(2.0±0.7和2.5±0.7mm,p = 0.02)和最大渗透深度(4.0±0.9和5.0±1.6mm,p = 0.02)均显著深于HM组。在HM组和VM组中,术前Hounsfield单位值与平均渗透深度的相关性分别为r = -0.617(p < 0.01)和r = -0.373(p = 0.01)。
与手工搅拌和手工填充技术相比,真空搅拌并使用骨水泥枪的骨水泥固定技术即使在骨硬化部位也能实现更深的骨水泥渗透。