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Does a simple syringe applicator enhance bone cement set up time in knee arthroplasty?

  
@article{ATM17556,
	author = {Nipun Sodhi and Sarah E. Dalton and Anton Khlopas and Assem A. Sultan and Gannon L. Curtis and Matthew A. Harb and Qais Naziri and Jared M. Newman and John W. Barrington and Michael A. Mont},
	title = {Does a simple syringe applicator enhance bone cement set up time in knee arthroplasty?},
	journal = {Annals of Translational Medicine},
	volume = {5},
	number = {Suppl 3},
	year = {2017},
	keywords = {},
	abstract = {Background: The time required for polymethylmethacrylate (PMMA) cement curing or hardening can be modified by a number of variables including the mixing technique, and the temperature and pressure at which the process is taking place. Therefore, the purpose of this study was to evaluate two different methods of PMMA application in terms of set up time. Specifically, we (I) compared the PMMA set up time of cement that remained in the mixing bowl to cement that was placed in a syringe and (II) extrapolated the associated annual cost difference on the national and individual surgeon levels. 
Methods: The cement set up time was measured for a total of 146 consecutive patients who underwent either unicompartmental knee arthroplasty (n=136) or patellofemoral arthroplasty (n=10) between January 2016 and April 2017. One pack of PMMA powder and monomer were mixed, placed in a 300 mL small plastic bowl, and mixed with a tongue depressor. Then, 50 mL of the mixed PMMA was placed in a sterile 60 mL syringe with the tip cut to a 6-mm opening, and the syringe was used to apply the cement to the bone and the prosthesis surface. The remaining unused cement in the syringe (syringe group) and the remaining unused cement in the plastic bowl (bowl group) were removed and formed into a two separate 2 cm diameter cubes that were allowed to cure at room temperature on a sterile set of osteotomes. The two cubes of cement were timed for complete PMMA curing. A two-tailed student’s t-test was used to compare the curing time for the two groups. Annual cost differences were calculated on the national and individual surgeon level. The total number of daily cases performed and the operative time savings using the syringe applicator was used to find daily and annual cost savings. 
Results: The mean time for the cement to set up in the bowl group was 16.8±2.1 minutes, and the mean time for cement set up in the syringe group was 15.1±1.7 minutes. Compared to the bowl group cement set up time, the syringe group set up time was significantly lower (P},
	issn = {2305-5847},	url = {https://atm.amegroups.org/article/view/17556}
}