The Journal of Arthroplasty
Volume 22, Issue 1 , Pages 95-99, January 2007

How Much Sterile Saline Should be Used for Efficient Lavage During Total Knee Arthroplasty? Effects of Pulse Lavage Irrigation on Removal of Bone and Cement Debris

  • Yasuo Niki

      Affiliations

    • Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
    • Istitute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
    • Corresponding Author InformationReprint requests: Yasuo Niki, MD, PhD, Institute of Rheumatology, Tokyo Women's Medical University, 10-22, Kawadacho, Shinjuku-ku, Tokyo 160-0054, Japan. Address correspondence to: Department of Orthopaedic Surgery, Keio University, 35, Shinanomachi, Shinjuku, Tokyo 162-0054, Japan.
    • ,
  • Hideo Matsumoto

      Affiliations

    • Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
    • ,
  • Toshiro Otani

      Affiliations

    • Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan
    • ,
  • Taisuke Tomatsu

      Affiliations

    • Istitute of Rheumatology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
    • ,
  • Yoshiaki Toyama

      Affiliations

    • Department of Orthopaedic Surgery, Keio University, Shinjuku-ku, Tokyo, Japan

Received 30 August 2005; accepted 1 February 2006. published online 14 April 2006.

Abstract 

Bone and polymethyl methacrylate (PMMA) debris particles generated during total knee arthroplasty (TKA) reportedly cause third-body wear. The present study investigated the volume of pulse lavage sufficient for removal of intraoperative PMMA and bone particles. Subjects comprised 8 patients who underwent cemented TKA. Pulse lavage with 8 L of sterile saline was performed using a pulsatile irrigator. During pulse lavage, aspirated fluid was collected in a 1-L aliquot, and the number and size of bone and PMMA particles in each fluid were measured. Image analysis revealed that the number of particles peaked at first lavage and gradually decreased until eighth lavage. Significant differences were found between the first vs second, second vs third, and third vs fourth lavage. However, no significant differences were found beyond the fourth lavage. This study indicated that 4 L of pulse lavage is effective for removing the particles during cemented TKA.

Key words: cement debris, third-body wear, pulse lavage, total knee arthroplasty

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 No benefits of funds were received in support of the study.

PII: S0883-5403(06)00071-4

doi:10.1016/j.arth.2006.02.078

The Journal of Arthroplasty
Volume 22, Issue 1 , Pages 95-99, January 2007

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