Abstract
We describe the use of a dental tool for the removal of excess cement during unicompartmental knee arthroplasty (UKA).
Retained excess cement following UKA is a well recognised complication. It may result in pain, impingement, loose body symptoms, vascular problems and damage to the prosthesis or structures within the lateral compartment. Symptomatic patients require additional surgery to manage such complications. The removal of excess cement becomes technically difficult during cementation of the prosthesis because there is limited surgical exposure. Consequently, the incidence of retained excess cement associated with minimally invasive knee arthroplasty ranges from 8 to 21%.
The senior author uses a ‘flat plastic’ dental instrument that is ideally shaped for use in UKA. The tool has blunt ends aligned at 90 degrees to each other which are perfectly angled to allow the rapid removal of excess cement from the femoral component and tibial tray during prosthesis insertion. It can be manoeuvred easily to break off excess bits of cement and also to retrieve them by sweeping around the prostheses from back to side. It is also used to assess alignment of the tibial tray medially and posteriorly to feel for over or under hang.
The ‘flat plastic’ dental tool helps to avoid retained excess cement and its associated complications in UKA, and is applicable in other minimally invasive arthroplasty procedures.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
