The Effect of Tourniquet Use and Sterile Carbon Dioxide Gas Bone Preparation on Cement Penetration in Primary Total Knee Arthroplasty.

Autor: Gapinski ZA; Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN., Yee EJ; Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN., Kraus KR; Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN., Deckard ER; Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN., Meneghini RM; Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health Physicians, Orthopedics & Sports Medicine, IU Health Hip & Knee Center, Fishers, IN.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2019 Aug; Vol. 34 (8), pp. 1634-1639. Date of Electronic Publication: 2019 Mar 28.
DOI: 10.1016/j.arth.2019.03.050
Abstrakt: Background: Tourniquetless total knee arthroplasty (TKA) is experiencing resurgence in popularity due to potential pain control benefits. Furthermore, optimal cement technique and implant fixation remain paramount to long-term cemented TKA success, as aseptic loosening continues to be a leading cause of revision. The purpose of this study is to determine how tourniquet use and/or novel bone preparation using sterile, compressed carbon dioxide (CO 2 ) gas affected cement penetration in TKA.
Methods: A retrospective review was performed on 303 consecutive primary TKAs with the same implant in 3 groups: (1) a tourniquet without sterile CO 2 compressed gas used for bone preparation, (2) no tourniquet with CO 2 gas, and (3) tourniquet use and CO 2 gas bone preparation. Cement penetration was measured on radiographs by two independent, blinded raters across 7 zones defined by the Knee Society Radiographic Evaluation System.
Results: The 3 groups did not differ on age, body mass index, or gender (P ≥ .1). Cement penetration was greater in 6 of 7 zones with significantly greater cement penetration in 3 zones (tibial anteroposterior zone 2, femoral lateral zones 3A and 3P) in groups that utilized CO 2 gas bone preparation compared to the tourniquet only group (P ≤ .039).
Conclusion: Bone prepared with CO 2 gas showed significantly more cement penetration in 3 zones with greater cancellous bone. The results suggest that use of CO 2 gas bone preparation may achieve greater cement penetration than using a tourniquet with lavage only.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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