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Patellar component stability improves with pulsatile lavage in total knee arthroplasty
Ruediger J Weiss1, Christian Heisel, Steffen J Breusch
1Department of Orthopaedic Surgery, Karolinska Hospital, 17176 Stockholm, Sweden. ruediger_weiss@hotmail.com
International Orthopaedics
|February 13, 2003
Summary
Jet lavage significantly improves cement penetration and component stability in patellar resurfacing compared to syringe lavage. This study supports routine jet lavage use for better cemented patellar component outcomes.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Patellar resurfacing is a common procedure in total knee arthroplasty.
- Adequate cement interdigitation and component stability are crucial for long-term success.
- Current methods for preparing the patellar bed, such as syringe lavage, may be suboptimal.
Purpose of the Study:
- To compare the efficacy of jet lavage versus syringe lavage.
- To evaluate their impact on cement penetration into the patellar bed.
- To assess the stability of the cemented polyethylene patellar component.
Main Methods:
- A cadaver study using 37 fresh frozen human patella pairs.
- Preparation of the patellar bed using either jet lavage or syringe lavage.
- Analysis of cement penetration via sagittal sections.
- Pullout testing of patellar components to determine mechanical failure strength.
Main Results:
- Jet lavage demonstrated significantly greater cement penetration (P<0.0001) compared to syringe lavage.
- Patellar components secured with jet lavage showed significantly greater mechanical failure force (P<0.0001).
- These findings indicate enhanced stability with jet lavage.
Conclusions:
- Jet lavage is superior to syringe lavage for preparing the patellar bed.
- Routine use of jet lavage is recommended for cemented patellar resurfacing.
- Improved cement penetration and component stability can be achieved with jet lavage.