鉴于最近有关不同水泥和植入物对全膝关节置换术(TKA)中无菌故障率的影响的担忧,我们想知道胶结技术是否可以发挥作用。本综述的主要目的是收集和比较来自八家骨科植入物制造商的外科医生教育材料,以评估制造商推荐的TKA胶结技术,并确定这些现成的指南中是否存在关于其植入物胶结最佳实践的一致性。
我们回顾了八家制造商提供的所有TKA系统的当代外科医生教育指南。变量包括:水泥类型,准备好的批次,应用前的表面处理,清洁和/或干燥骨骼表面,搅拌水泥,水泥在施用前混合后的等待阶段,加压水泥,水泥应用的位置,和固化时间。记录并组织数据以进行定性比较。
我们确定了总共43个导向器,涵盖了来自8个不同制造商的38个植入物。制造商提供了41个手术技术指南和两个有关胶结技术的一般手册。即使在制造商自己的不同植入物指南中,在胶结技术的许多方面有各种各样的不同指南。
对于TKA期间胫骨基板胶结的首选胶结技术,制造商内部和制造商之间的外科医生教育材料显然没有共识。为了减少与无菌性松动相关的TKA失败的数量,可能需要努力确定最佳实践的胶结技术。
Given recent concerns regarding the influence of different cements and implants on the rate of aseptic failures in total knee arthroplasty (TKA), we wondered if cementation technique could play a role. The primary aim of this review was to collect and compare the surgeon education materials from eight orthopedic implant manufacturers to evaluate the manufacturers\' recommended cementation technique in TKA and identify if there was any consistency in these readily available guides as to the best practices of cementation of their implants.
We reviewed contemporary surgeon education
guidelines for all TKA systems available from eight manufacturers. Variables included: cement type, batches prepared, surface preparation prior to application, cleaning and/or drying the bone surface, mixing the cement, the waiting phase after the cement has been mixed prior to application, pressurizing the cement, location of cement application, and the curing time. Data were recorded and organized for qualitative comparisons.
We identified a total of 43 guides covering 38 implants from eight different manufacturers. There were 41 surgical technique guides and two general brochures regarding cementation techniques available from the manufacturers. Even within the manufacturers\' own
guidelines for the different implants, there was a wide variety of differing
guidelines on many aspects of the
cementation technique.
There is clearly no
consensus for a preferred
cementation technique both within and among manufacturers\' surgeon education materials regarding tibial baseplate
cementation during TKA. Efforts may be needed to identify a best-practice cementation technique in an effort to reduce the number of TKA failures associated with aseptic loosening.