Using suction in back-bleeding conditions increases cement penetration without the need for a tourniquet.

Autor: London E; University of Bristol and Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom., Hernandez BA; Department of Mechanical Engineering, University of Bath, Bath, United Kingdom., Murray J; University of Bristol and Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom., Gill HS; Department of Mechanical Engineering, University of Bath, Bath, United Kingdom; Centre for Therapeutic Innovation, University of Bath, Bath, United Kingdom. Electronic address: r.gill@bath.ac.uk.
Jazyk: angličtina
Zdroj: Medical engineering & physics [Med Eng Phys] 2022 Jun; Vol. 104, pp. 103807. Date of Electronic Publication: 2022 Apr 22.
DOI: 10.1016/j.medengphy.2022.103807
Abstrakt: Background: The majority of total knee arthroplasties are performed with a tourniquet as it is perceived this gives rise to superior cement fixation. Tourniquets, however, have been associated with increased pain, post-operative swelling, and reduced knee range of movement which can all detrimentally impact patient recovery. This laboratory-based study aimed to assess if it is possible to achieve equivalent (or even enhanced) cementation without a tourniquet using a novel suction device.
Methods: Cement penetration was compared between conditions simulating bone with back-bleeding with and without the use of suction in open-cell rigid foam tibia models and porcine specimens. Suction was applied via a urinary catheter inserted into the tibial recess created for the implant's stem. Cement penetration depth was measured from micro-CT scans. The pull-off strength of cemented tibial implant analogues in porcine specimens with and without suction was also assessed.
Results: Suction gave rise to a significant (p = 0.028) increase in cement penetration depth in both the rigid foam, 5.4 - 6.6 mm, and porcine specimens, 0.7 - 1.0 mm. A non-significant increase in implant pull-off strength was also observed.
Conclusion: Suction during cementation in a back-bleeding model resulted in significantly greater cement penetration depth. Using suction surgeons can avoid potential disadvantages of tourniquet use without compromising cementation.
(Copyright © 2022. Published by Elsevier Ltd.)
Databáze: MEDLINE
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