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General Orthopaedics

CEMENTATION INDEX IN TOTAL ELBOW ARTHROPLASTY: CAN IT PREDICT FAILURE?

The Indian Orthopaedic Society (UK) (IOSUK)



Abstract

Introduction

The aim of this study is to analyse the effect of the degree of coverage of the Total Elbow implant with cement and the significance of cementation index as a predictor of failure.

Material/methods

Fifty elbows in forty seven patients who had undergone the Coonrad-Morrey TER were included in the study. The post-operative radiographs were evaluated for the cementation index. Failures and revisions were documented. Statistical analysis was done to evaluate the cementation index as a predictor of failure.

Results

The mean period of follow up was 4.67 ± 2.85 years. The mean cementation index of the humerus (CIH) was 1.22 ± 0.28 (range 0.7 to 2.1). The mean cementation index of the ulna (CIU) was 1.10 ± 0.18 (range 0.77 to 1.72). The Kolmogorov-Smirnov test, used to test the type of distribution, showed that both the indices had a normal distribution (p > 0.05). Both the humeral and ulnar cementation indices were not found to be statistically significant predictors of failure (p > 0.05).

Conclusions

The cementation index is an objective method of assessment of the coverage of the implant with cement. In the present series, the cementation index of the humerus varied from 0.7 to 2.1 and that of the ulna varied from 0.77 to 1.72 but both were not found to be statistically significant. A larger study with adequate follow-up should be done to establish the minimum cement mantle that can be considered adequate for the long term survivorship of the prosthesis.