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Pulse-lavage brushing followed by hydrogen peroxide-gauze packing for bone-bed preparation in cemented total hip
David C Ackland1, Vincent Yap, Margaret L Ackland
1Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria, Australia. dackland@unimelb.edu.au
Purpose:
To compare the effectiveness of pulse-lavage brushing followed by hydrogen peroxide-gauze packing with either technique alone or normal-saline irrigation in bone-bed preparation for cemented total hip arthroplasty.
Methods:
44 fresh-frozen ox femoral canals were prepared for cemented total hip arthroplasty using 4 techniques: normal-saline irrigation, pulse-lavage brushing, hydrogen peroxide-soaked gauze packing, and a combination of the latter 2 techniques. The maximum tensile pull-out force required to separate the prosthesis from the femoral canal was measured as an indicator of the strength of the cement-bone interface.
Results:
The mean pull-out force to separate the prosthesis from the femoral canal was significantly higher in specimens prepared with pulse-lavage brushing followed by hydrogen peroxide-soaked gauze packing or pulse-lavage brushing alone than those prepared with normal-saline irrigation or hydrogen peroxide-soaked gauze packing alone (p<0.001).
Conclusions:
Pulse-lavage brushing is more effective at cleansing the femoral canal and increasing mechanical strength at the cement-bone interface than preparation with normal-saline irrigation or hydrogen peroxide-soaked gauze packing.
