The role of lavage in preventing hemodynamic and blood-gas changes during cemented arthroplasty

An experimental model was designed to investigate the role of meticulous intramedullary lavage in the prevention of the blood-gas and hemodynamic changes that have been documented to occur during cemented arthroplasty. Twenty-one adult mongrel dogs were divided into two groups. One group had the medullary canal thoroughly lavaged prior to insertion of the cement and prosthesis and the other group had no lavage. The results clearly showed that careful lavage can eliminate the significant decreases in arterial PO2 and increases in intrapulmonary shunt fraction and pulmonary artery pressure that were evident in the group that did not have lavage. Femoral medullary reaming was investigated and was shown not to compromise the dogs' cardiopulmonary status.

During cemented arthroplasty, thorough lavage of a plugged medullary canal prior to insertion of the cement and prosthesis is a highly effective prophylactic measure in the elimination of gas-exchange and hemodynamic complications.