The effect of irrigating solutions on the strength of the cement-bone interface

Irrigating solutions are commonly used in the preparation of bony surfaces before total joint replacement components are cemented. Using an experimental cemented arthroplasty model, metal pseudo-prostheses were cemented to a cadaveric bone surface prepared with a specific irrigating solution. A tension load was then applied to the prosthesis until failure occurred at the cement-bone interface. A quantitative analysis of the effect of three commonly used irrigating solutions on the strength of the cement-bone interface is presented. Sixty trials were performed with normal saline, povidone iodine and hydrogen peroxide. Irrigation with hydrogen peroxide afforded statistically superior cement fixation in this arthroplasty model when compared with either normal saline or povidone iodine (P less than 0.01 Chi-squared test).