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New Study Shows Use of Kinamed’s CarboJet® System Yields Increased Bone Cement Penetration in Total Knee Arthroplasty, Even When No Tourniquet Is Used

August 7, 2019

August 7, 2019


Camarillo, California – A new clinical study published in the Journal of Arthroplasty demonstrates that use of the CarboJet CO2 Bone Preparation System from Kinamed Incorporated yields increased bone cement penetration in total knee arthroplasty (TKA), even during tourniquetless surgery in which a thigh tourniquet was not used to control bleeding at any time during the procedure.


As stated in the study, “Tourniquetless TKA is experiencing resurgence in popularity due to potential pain control benefits. Furthermore, optimal cement technique and implant fixation remain paramount to long-term cemented TKA success, as aseptic loosening continues to be a leading cause of revision.”  The study notes that aseptic loosening remains one of the primary causes for early and late revisions, with up to 28.7% of all revisions being due to aseptic loosening.


The study authors also note that “Increasing the amount of cement into the tibial and femoral bone (cement penetration) has been shown to provide a stronger bone-cement interface which leads to increased stability and long-term survivorship of the implants.” Achieving appropriate penetration and inter-digitation of bone cement is therefore important for ensuring the overall success of TKA.


This new study, performed by R. Michael Meneghini M.D. and colleagues at the Indiana University School of Medicine, compared cement penetration in three groups of TKA patients: (1) tourniquet without CO2 gas bone preparation, (2) no tourniquet with CO2 gas bone preparation, and (3) tourniquet with CO2 gas bone preparation.  The results show that when sterile compressed CO2 gas is used for bone preparation, cement penetration is actually increased in not only the tourniquet (group 3) but also in the no-tourniquet group (group 2), as compared to the tourniquet group in which CO2 gas was not used (group 1).


An earlier study conducted by Dr. Meneghini and colleagues compared TKA groups with and without use of the thigh tourniquet and demonstrated that female patients in the no-tourniquet group experienced significantly less post-operative pain and consumed fewer opioids as compared to female patients in the tourniquet group.  Their work has important implications given the scope of the opioid crisis and the very large number of knee replacements being performed in the United States.

About Kinamed

Kinamed is a leading developer, manufacturer, and distributor of innovative specialty orthopedic, neurosurgical, and cardiothoracic medical devices.  In addition to the CarboJet system, Kinamed’s other orthopedic products include: the SuperCable® Iso-Elastic Polymer Cerclage system: a revolutionary cabling system that eliminates problems associated with traditional metal cables; and the KineMatch® Patello-Femoral Replacement: a patient–specific (custom) unicompartmental joint replacement implant. Since the company’s founding, Kinamed has manufactured and sold over 2.5 million surgical implants.

For additional information on Kinamed, Inc., please visit

Dr. Meneghini is a consultant for Kinamed.

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