Comparison of caulking gun and standard cement gun using for femoral cementation.

BACKGROUND Currently the standard femoral cementing technique requires cement injection gun to deliver bone cement into the femoral canal. The standard cement gun is expensive and must be imported. There is no previous study about the use of a household caulking gun for femoral cementation. OBJECTIVE To compare the radiographic quality of cementing technique in proximal femur between using standard cement gun and caulking gun. MATERIAL AND METHOD Experimental study was performed on ten pairs of adult bovine femora. After the proximal femoral canal was prepared for cementation, each pair of bovine femora was randomly selected to be injected with bone cement with a standard cement gun in one side. The other side was injected with a caulking gun and the authors' invented kit. The prosthesis was inserted and radiographs were taken. Radiographic quality of cement interdigitation was evaluated by the modified Barrack's cement grading score. Cement distribution was categorized into 14 zones of Gruen. The data was statistically analyzed by Wilcoxon matched pairs signed-rank test. The inter-observer and intra-observer agreement was analyzed by Kappa analysis. RESULTS Radiographic quality score of femoral cementation in the group using the caulking gun was not statistically different from in the group using the standard gun in all 14 Gruen zones (p > 0.05). Intra-observer and inter-observer agreement were moderate (Kappa = 0.71 and 0.59 respectively). CONCLUSION The radiographic quality of femoral cementation using the caulking gun was not significantly different from the standard cement gun. The caulking gun and invented kit could be applied in clinical use and save the operative cost.