Article

Mechanical loosening is the most common cause of revision in
unicompartmental knee arthroplasty. We determined the effect of bone lavage on
tibial cement penetration and interface temperature with controlled ligament
tension forces. We presumed pulsed lavage would allow increased cement
penetration compared with syringe lavage. METHODS: Cemented unicompartmental knee
arthroplasty was performed in 12 pairs of fresh-frozen knees. Lavage was
performed using pulsed lavage on one side (A) and syringe lavage on the other
(B). Cement penetration pressure, interface temperature, and ligament tension
forces were continuously monitored during the operation. Screened radiographs
were taken and cement penetration under the tibial plateau was measured.
FINDINGS: The pulsed lavage group showed a mean cement penetration area of 187.24
(SD 36.37) mm(2), whereas 144.29 (SD 35.74) mm(2) was measured in the group with
syringe lavage. Cement penetration pressure was 13.29 (SD 8.69) kPa in Group A
and 20.21 (SD 7.78) kPa in Group B. Maximum interface temperatures of 46.99
degrees C were observed in Group A and 45.02 degrees C in Group B.
INTERPRETATION: Our data showed pulsed lavage cleansing of the cancellous tibial
bone substantially improved cement penetration compared with syringe lavage
without reaching the temperature threshold for bone necrosis. We recommend the
routine use of pulsed lavage to improve long-term fixation.
CI - Copyright (c) 2011 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS