A quantitative analysis of two cementing techniques in total elbow replacement: A cadaveric study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Materials Science

Background:

• Loosening of the ulnar component is a primary reason for total elbow replacement failure.
• Current cementing techniques for the ulnar component may be suboptimal.
• Availability of specialized equipment like small nozzle cement guns can be a limitation.

Purpose of the Study:

• To compare the effectiveness of cement gun versus syringe for cementing the ulnar component in total elbow arthroplasty.
• To evaluate the impact of cementing technique on the filling of the ulnar intramedullary canal.
• To determine if a cement gun with a small nozzle improves cement fill compared to a syringe.

Main Methods:

• A cadaveric study was conducted using paired ulnar specimens.
• Cementation was performed using either a cement gun with a small nozzle or a syringe.
• A 3D printed ulnar component was inserted, followed by computed tomography scanning.
• 3D reconstructions were used to analyze the degree of intramedullary canal filling.

Main Results:

• The cement gun group demonstrated a significantly higher degree of ulnar canal filling (63.3%) compared to the syringe group (52.7%).
• A greater degree of filling was observed in 85.7% of specimens cemented with the gun.
• Statistical analysis showed a significant difference (p < 0.05) in filling between the two methods.

Conclusions:

• The use of a cement gun with a specific small nozzle leads to significantly better filling of the ulnar canal.
• This technique is recommended for cementing the ulnar component in total elbow arthroplasty to potentially improve implant fixation.
• Optimizing cementation technique can address a key factor in total elbow replacement failure.