Comparison of Caulking Gun and Standard Cement Gun using for Femoral Cementation
Anuwat Pongkunakorn MD*, Nuttawut Pengkong MD*, Wachara Maneeratroj MD*
Affiliation : * Department of Orthopaedic Surgery, Lampang Hospital and Medical Education Center, Lampang
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.
Keywords : Femoral cementation, Cementing technique, Caulking gun, Cement gun, Invented, Hip replace- ment surgery
