INTRODUCTION: The purpose of this experimental study was to determine quantitatively the cement penetration into periprosthetic femoral bone by Icomparing the use of jet-lavage with the conventional syringe irrigation. METHODS: 10 pairs of fresh-frozen human cadaver femora were used for cemented stem implantation, The left femora were irrigated with a syringe device, the right femora with a jet-lavage system. After implantation, all femora were cut into 5-mm slices from proximal to distal with a diamond saw. The scanned slices were analysed using an image processing system which provided a discrimination between implant, cement, and bone as well as an exact determination of the cement area. RESULTS: In all 10 femora, a recognizable improvement of the cement penetration into the periprosthetic bone was demonstrated using the jet-lavage. In the proximal part, the mean cement penetration was 8.6% higher in the jet-lavage group than in the syringe device group. An equivalent tendency towards the jet-lavage pretreated femora was seen in the middle part with 8.7% on average mean and in the distal part with 6.4% on average. Also, when subdividing the periprosthetic area into 4 quadrants, a significant improvement of the cement penetration was found with the exception of the ventro-medial region. CONCLUSION: Cement distribution and penetration is improved using the jet-lavage technique for cleaning the medullary canal of the femur. Therefore, the jet-lavage should be used as a standard procedure in clinical cementing techniques.
INTRODUCTION: The purpose of this experimental study was to determine quantitatively the cement penetration into periprosthetic femoral bone by Icomparing the use of jet-lavage with the conventional syringe irrigation. METHODS: 10 pairs of fresh-frozen human cadaver femora were used for cemented stem implantation, The left femora were irrigated with a syringe device, the right femora with a jet-lavage system. After implantation, all femora were cut into 5-mm slices from proximal to distal with a diamond saw. The scanned slices were analysed using an image processing system which provided a discrimination between implant, cement, and bone as well as an exact determination of the cement area. RESULTS: In all 10 femora, a recognizable improvement of the cement penetration into the periprosthetic bone was demonstrated using the jet-lavage. In the proximal part, the mean cement penetration was 8.6% higher in the jet-lavage group than in the syringe device group. An equivalent tendency towards the jet-lavage pretreated femora was seen in the middle part with 8.7% on average mean and in the distal part with 6.4% on average. Also, when subdividing the periprosthetic area into 4 quadrants, a significant improvement of the cement penetration was found with the exception of the ventro-medial region. CONCLUSION: Cement distribution and penetration is improved using the jet-lavage technique for cleaning the medullary canal of the femur. Therefore, the jet-lavage should be used as a standard procedure in clinical cementing techniques.
Authors: Michael Clarius; Christian Hauck; Joern B Seeger; Andrew James; David W Murray; Peter R Aldinger Journal: Int Orthop Date: 2009-02-14 Impact factor: 3.075