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Published in: Journal of Orthopaedic Surgery and Research 1/2009

Open Access 01-12-2009 | Technical Note

Improving accuracy of total knee component cementation: description of a simple technique

Authors: William B Lutes, Michael A Flierl, Michael R Dayton, Steven J Morgan

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2009

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Abstract

Background

Total knee arthroplasty represents a common orthopedic surgical procedure. Achieving proper alignment of its components with the predrilled patellar and tibial peg holes prior to polymerization of the bone cement can be challenging.

Technique

After establishing the femoral, patellar and tibial bone cuts, the cancellous bone around the tibial keel, as well as the peg holes for the patella and femoral components are marked with methylene blue using a cotton swab stick. If bone cement is then placed onto the cut and marked bone edges, the methylene blue leaches through the bone cement and clearly outlines the tibial keel and predrilled femoral and patellar peg holes. This allows excellent visualization of the bone preparations for each component, ensuring safe and prompt positioning of TKA components while minimizing intraoperative difficulties with component alignment while the cement hardens.

Conclusion

The presented technical note helps to improve the accuracy and ease of insertion when the components of total knee arthroplasty are impacted to their final position.
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Literature
1.
go back to reference Badley EM, Wang PP: Arthritis and the aging population: projections of arthritis prevalence in Canada 1991 to 2031. J Rheumatol. 1998, 25 (1): 138-144.PubMed Badley EM, Wang PP: Arthritis and the aging population: projections of arthritis prevalence in Canada 1991 to 2031. J Rheumatol. 1998, 25 (1): 138-144.PubMed
2.
go back to reference Gignac MA, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin PR, Badley EM: "What do you expect? You're just getting older": A comparison of perceived osteoarthritis-related and aging-related health experiences in middle- and older-age adults. Arthritis Rheum. 2006, 55 (6): 905-912. 10.1002/art.22338.CrossRefPubMed Gignac MA, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin PR, Badley EM: "What do you expect? You're just getting older": A comparison of perceived osteoarthritis-related and aging-related health experiences in middle- and older-age adults. Arthritis Rheum. 2006, 55 (6): 905-912. 10.1002/art.22338.CrossRefPubMed
3.
go back to reference Perruccio AV, Power JD, Badley EM: Revisiting arthritis prevalence projections--it's more than just the aging of the population. J Rheumatol. 2006, 33 (9): 1856-1862.PubMed Perruccio AV, Power JD, Badley EM: Revisiting arthritis prevalence projections--it's more than just the aging of the population. J Rheumatol. 2006, 33 (9): 1856-1862.PubMed
4.
go back to reference Callahan CM, Drake BG, Heck DA, Dittus RS: Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA. 1994, 271 (17): 1349-1357. 10.1001/jama.271.17.1349.CrossRefPubMed Callahan CM, Drake BG, Heck DA, Dittus RS: Patient outcomes following tricompartmental total knee replacement. A meta-analysis. JAMA. 1994, 271 (17): 1349-1357. 10.1001/jama.271.17.1349.CrossRefPubMed
5.
go back to reference Robertsson O, Knutson K, Lewold S, Lidgren L: The Swedish Knee Arthroplasty Register 1975-1997: an update with special emphasis on 41,223 knees operated on in 1988-1997. Acta Orthop Scand. 2001, 72 (5): 503-513. 10.1080/000164701753532853.CrossRefPubMed Robertsson O, Knutson K, Lewold S, Lidgren L: The Swedish Knee Arthroplasty Register 1975-1997: an update with special emphasis on 41,223 knees operated on in 1988-1997. Acta Orthop Scand. 2001, 72 (5): 503-513. 10.1080/000164701753532853.CrossRefPubMed
6.
go back to reference Birrell F, Johnell O, Silman A: Projecting the need for hip replacement over the next three decades: influence of changing demography and threshold for surgery. Ann Rheum Dis. 1999, 58 (9): 569-572. 10.1136/ard.58.9.569.PubMedCentralCrossRefPubMed Birrell F, Johnell O, Silman A: Projecting the need for hip replacement over the next three decades: influence of changing demography and threshold for surgery. Ann Rheum Dis. 1999, 58 (9): 569-572. 10.1136/ard.58.9.569.PubMedCentralCrossRefPubMed
7.
go back to reference Moran CG, Horton TC: Total knee replacement: the joint of the decade. A successful operation, for which there's a large unmet need. BMJ. 2000, 320 (7238): 820-10.1136/bmj.320.7238.820.PubMedCentralCrossRefPubMed Moran CG, Horton TC: Total knee replacement: the joint of the decade. A successful operation, for which there's a large unmet need. BMJ. 2000, 320 (7238): 820-10.1136/bmj.320.7238.820.PubMedCentralCrossRefPubMed
8.
go back to reference Moreland JR: Mechanisms of failure in total knee arthroplasty. Clin Orthop Relat Res. 1988, 226: 49-64.PubMed Moreland JR: Mechanisms of failure in total knee arthroplasty. Clin Orthop Relat Res. 1988, 226: 49-64.PubMed
9.
go back to reference Lotke PA, Ecker ML: Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am. 1977, 59 (1): 77-79.PubMed Lotke PA, Ecker ML: Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am. 1977, 59 (1): 77-79.PubMed
10.
go back to reference Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L: Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res. 2001, 392: 46-55. 10.1097/00003086-200111000-00006.CrossRefPubMed Barrack RL, Schrader T, Bertot AJ, Wolfe MW, Myers L: Component rotation and anterior knee pain after total knee arthroplasty. Clin Orthop Relat Res. 2001, 392: 46-55. 10.1097/00003086-200111000-00006.CrossRefPubMed
11.
go back to reference Matsuda S, Miura H, Nagamine R, Urabe K, Hirata G, Iwamoto Y: Effect of femoral and tibial component position on patellar tracking following total knee arthroplasty: 10-year follow-up of Miller-Galante I knees. Am J Knee Surg. 2001, 14 (3): 152-156.PubMed Matsuda S, Miura H, Nagamine R, Urabe K, Hirata G, Iwamoto Y: Effect of femoral and tibial component position on patellar tracking following total knee arthroplasty: 10-year follow-up of Miller-Galante I knees. Am J Knee Surg. 2001, 14 (3): 152-156.PubMed
12.
go back to reference Scuderi GR, Komistek RD, Dennis DA, Insall JN: The impact of femoral component rotational alignment on condylar lift-off. Clin Orthop Relat Res. 2003, 410: 148-154. 10.1097/01.blo.0000063603.67412.ca.CrossRefPubMed Scuderi GR, Komistek RD, Dennis DA, Insall JN: The impact of femoral component rotational alignment on condylar lift-off. Clin Orthop Relat Res. 2003, 410: 148-154. 10.1097/01.blo.0000063603.67412.ca.CrossRefPubMed
13.
go back to reference D'Lima DD, Chen PC, Colwell CW: Polyethylene contact stresses, articular congruity, and knee alignment. Clin Orthop Relat Res. 2001, 392: 232-238. 10.1097/00003086-200111000-00029.CrossRefPubMed D'Lima DD, Chen PC, Colwell CW: Polyethylene contact stresses, articular congruity, and knee alignment. Clin Orthop Relat Res. 2001, 392: 232-238. 10.1097/00003086-200111000-00029.CrossRefPubMed
14.
go back to reference Ritter MA, Faris PM, Keating EM, Meding JB: Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994, 299: 153-156.PubMed Ritter MA, Faris PM, Keating EM, Meding JB: Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994, 299: 153-156.PubMed
15.
go back to reference Berend ME, Ritter MA, Meding JB, Faris PM, Keating EM, Redelman R, Faris GW, Davis KE: Tibial component failure mechanisms in total knee arthroplasty. Clin Orthop Relat Res. 2004, 428: 26-34. 10.1097/01.blo.0000148578.22729.0e.CrossRefPubMed Berend ME, Ritter MA, Meding JB, Faris PM, Keating EM, Redelman R, Faris GW, Davis KE: Tibial component failure mechanisms in total knee arthroplasty. Clin Orthop Relat Res. 2004, 428: 26-34. 10.1097/01.blo.0000148578.22729.0e.CrossRefPubMed
16.
go back to reference Chen AF, Alan RK, Redziniak DE, Tria AJ: Quadriceps sparing total knee replacement. The initial experience with results at two to four years. J Bone Joint Surg Br. 2006, 88 (11): 1448-1453. 10.1302/0301-620X.88B11.18052.CrossRefPubMed Chen AF, Alan RK, Redziniak DE, Tria AJ: Quadriceps sparing total knee replacement. The initial experience with results at two to four years. J Bone Joint Surg Br. 2006, 88 (11): 1448-1453. 10.1302/0301-620X.88B11.18052.CrossRefPubMed
17.
go back to reference Dalury DF, Dennis DA: Mini-incision total knee arthroplasty can increase risk of component malalignment. Clin Orthop Relat Res. 2005, 440: 77-81. 10.1097/01.blo.0000185757.17401.7b.CrossRefPubMed Dalury DF, Dennis DA: Mini-incision total knee arthroplasty can increase risk of component malalignment. Clin Orthop Relat Res. 2005, 440: 77-81. 10.1097/01.blo.0000185757.17401.7b.CrossRefPubMed
18.
go back to reference Kuehn KD, Ege W, Gopp U: Acrylic bone cements: composition and properties. Orthop Clin North Am. 2005, 36 (1): 17-28. 10.1016/j.ocl.2004.06.010.CrossRefPubMed Kuehn KD, Ege W, Gopp U: Acrylic bone cements: composition and properties. Orthop Clin North Am. 2005, 36 (1): 17-28. 10.1016/j.ocl.2004.06.010.CrossRefPubMed
Metadata
Title
Improving accuracy of total knee component cementation: description of a simple technique
Authors
William B Lutes
Michael A Flierl
Michael R Dayton
Steven J Morgan
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2009
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-4-38

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