Cement use in total knee arthroplasty: 40 versus 80 grams |
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| Institution: | 1. Department of Orthopaedic Surgery, Gunma University, Maebashi, Gunma, Japan;2. Department of Orthopaedic Surgery, Gunma Central Hospital, Maebashi, Gunma, Japan;3. Department of Orthopaedic Surgery, Kiryu Orthopedic Hospital, Kiryu, Gunma, Japan;4. Department of Orthopaedic Surgery, Zensyukai Hospital, Maebashi, Gunma, Japan;1. University Hospital Plymouth, United Kingdom;2. Royal Devon &Exeter Hospital, United Kingdom;3. Southwest Orthopaedic Research Division, United Kingdom;1. The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry SY10 7AG, UK;2. Keele University, Staffordshire ST5 5BG, UK;1. Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, United Kingdom;2. Department of Orthopaedics, The University of Edinburgh, 49 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SA, United Kingdom;1. Department of Orthopedic Surgery, George Washington Hospital, Washington, DC, USA;2. Johns Hopkins Department of Orthopaedic Surgery, Adult Reconstruction Division, Columbia, MD, USA;3. Adult Reconstruction and Joint Replacement Division, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA;1. Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Headington, Oxford OX3 7LD, United Kingdom;2. Department of Zoology, University of Oxford, Mansfield Road, Oxford OX1 3ZS, United Kingdom;3. Centre for Therapeutic Innovation/Dept. of Mechanical Engineering, University of Bath, Bath BA2 7AY, United Kingdom |
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| Abstract: | BackgroundStudies of cement use in total knee arthroplasty (TKA) have historically addressed mechanical properties and application strategies. Recently, cement technique has been studied as a means to reduce cost. We transitioned from opening two bags (80 grams) of cement to one bag (40 grams) of cement for primary TKA to improve cost efficacy. This study investigates the radiographic outcome and cost of TKAs performed with 40 versus 80 grams of cement.MethodsTKAs from January 2017 to January 2019 were evaluated. Cement mantle and implant alignment were assessed per the Modern Knee Society Radiographic Evaluation System at four months by three blinded reviewers. Data was analyzed according to quantity of cement used. Cement mantle quality at 16 implant zones was compared. Cost was evaluated.Results163 patients (age 66.8 yrs. +/? 8.9, 51.5% female) underwent TKA with 80 grams of cement, while 142 patients (age 67.1 yrs. +/? 9.3, 56.3% female) underwent TKA utilizing 40 grams of cement. There was no significant difference in cement mantle quality. The most common zone of cement deficiency was the femoral posterior flange (9% in 40 gram group versus 4% in 80 gram group, p value = 0.08). There was no difference in implant size. Cost saving was calculated at $7,810 for the 40 gram group.ConclusionThere was no difference in radiographic cement mantle appearance between primary knees performed with 40 or 80 grams of cement. Cement usage represents a target for cost saving and opportunity to increase the value of primary TKA. Based on the current incidence of TKA in the United States, cost savings could exceed 33 million dollars annually. |
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| Keywords: | Total knee arthroplasty Cement Cost Value Polymethylmethacrylate |
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