Combined syringe cement pressurisation and intra-osseous suction: an effective technique in total knee arthroplasty

Our study looked at the short and medium-term results of a cost-effective technique of bone surface preparation and cement introduction in total knee arthroplasty (TKA). Numerous factors determine the outcome following TKA. Early failure and component loosening have been attributed to inadequate bone-cement and prosthesis-cement interfaces, established at the time of surgery. Various operative techniques have been reported to achieve effective cement penetration and inter-digitation into cancellous bone, with techniques of cement pressurization and intra-osseous suction being employed. We have devised a technique of cement pressurization using a modified standard 20 ml syringe, combined with intra-osseous suction. Retrospective evaluation of a series of 50 post-operative radiographs has shown that effective and even penetration of cement to a depth of 8.0 to 10.6 mm can be achieved consistently with this technique, during TKA, without the use of tourniquet. In addition evaluation of post-operative plain radiographs with minimum follow-up of 5 years showed 16 knees with minor, non-progressive lucent lines around the tibial component with a maximum Knee Society TKA Roentgenographic score of 2. To conclude we propose that this simple technique of surface preparation and cement introduction produces good results in the short and medium-term.