Department of Orthopaedic Surgery, University of Heidelberg, Schlierbacher Landstr. 200a, 69118 Heidelberg, Germany.
Int Orthop. 2011 Aug;35(8):1165-9. doi: 10.1007/s00264-010-1137-y. Epub 2010 Oct 16.
Pulsatile lavage is purported to improve radiographic survival in cemented total knee arthroplasty (TKA). Similarly, a potential improvement of fixation strength of the tibial tray has been assumed based on the increased cement penetration. In this study, the influence of pulsed lavage on fixation strength of the tibial component and bone cement penetration was evaluated in six pairs of cadaveric specimens. Following surgical preparation, the tibial surface was irrigated using pulsatile lavage on one side of a pair, while on the other side syringe lavage was applied. All tibial components were implanted using the same cementing technique. Cement penetration and bone mineral density was assessed based on computed tomography data. Fixation strength of the tibial trays was determined by a pull-out test with a material testing machine. Median pull-out forces and cement penetration were significantly (p = 0.031) improved in the pulsed lavage group as compared to the syringe lavage group. Enhanced fixation strength is suggested as being a key to improved survival of the implant. Consequently, pulsatile lavage should be considered as a mandatory preparation step when cementing tibial components in TKA.
脉冲冲洗据称可以提高骨水泥固定的全膝关节置换术（TKA）的影像学存活率。同样，基于增加的水泥渗透，假设胫骨托固定强度也会有所提高。在这项研究中，评估了脉冲冲洗对 6 对尸体标本中胫骨组件固定强度和骨水泥渗透的影响。在手术准备后，一侧的胫骨表面使用脉冲冲洗进行冲洗，而另一侧则使用注射器冲洗。所有胫骨组件均采用相同的粘固技术植入。基于计算机断层扫描数据评估水泥渗透和骨矿物质密度。使用材料试验机进行拔出试验来确定胫骨托的固定强度。与注射器冲洗组相比，脉冲冲洗组的胫骨托拔出力和水泥渗透中位数显著提高（p=0.031）。固定强度的提高被认为是提高植入物存活率的关键。因此，当在 TKA 中固定胫骨组件时，脉冲冲洗应被视为强制性的准备步骤。
