Comparison of different cementing techniques for cement penetration under tibial component in total knee arthroplasty: a retrospective observational study

Purpose: This study aimed to investigate the differences in cement penetration between cementing techniques in total knee arthroplasty (TKA).

Materials and methods: 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.

Results: 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.

Conclusion: 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.