Enhancing femoral cement fixation in total knee arthroplasty

Several factors have been shown to be associated with early development of radiolucent lines at the bone-cement interface in total knee arthroplasty (TKA). The posterior condylar surfaces, in particular, seem subject to poor cement technique, which could lead to early loosening. This study compares two cementation techniques in TKA, with respect to depth of cement penetration and radiolucency in the posterior condyles. All penetration depths were greater in group I (injected) versus group II (noninjected). Sixty-seven percent of group I showed penetration depths >1.5 mm compared with 23% of group II. No specimen in group I had gaps in the cement mantle on visual inspection or radiolucency on radiographic evaluation. No statistical differences, however, could be demonstrated between the two groups.