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Der Einfluss des Jet-Lavage-Systems auf das In-vitro-Zementierergebnis

The influence of jet-lavage systems on in vitro cement penetration

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Zusammenfassung

Fragestellung

Der positive Einfluss der pulsierenden Druckspülung (Jet-Lavage) auf das Zementierergebnis am proximalen Femur ist unumstritten. Auf dem Markt sind verschiedene System erhältlich, aber es ist nicht bekannt, ob es Unterschiede hinsichtlich der Qualität und Effektivität gibt.

Methode

Im Links-rechts-Vergleich wurden an 30 Paaren humaner Leichenfemora 4 unterschiedliche Jet-Lavage-Systeme untersucht. Nach Markraumpräparation wurden die Femora jeweils mit 1000 ml Spülflüssigkeit gespült und anschließend in Kunststoffzylinder eingegipst. Nach retrograder Zementapplikation erfolgte die Druckbeaufschlagung des Zements mit einer konstanten Kraft von 3000 N. Die Mikroradiogramme von den spiegelbildlich identisch angefertigten horizontalen Sägeschnitten wurden mittels Bildanalyse morphometrisch auf das Ausmaß der Zementpenetration ausgewertet.

Ergebnisse

Bezüglich der Zementpenetration in das spongiöse Lager fand sich kein signifikanter Unterschied zwischen den untersuchten Jet-Lavage-Systemen.

Schlussfolgerung

Für ein optimales Zementierergebnis ist die Verwendung der Jet-Lavage unverzichtbar. Die in unserer Studie untersuchten unterschiedlichen Jet-Lavage-Systeme scheinen eine vergleichbare Effizienz aufzuweisen.

Abstract

The benefit of pulsatile lavage on cement penetration in femoral cancellous bone is well known. The aim of this study was to determine the influence of different jet-lavage systems on cement penetration in a standardized cadaver study.

Four different jet-lavage systems were compared (right vs left) in 30 paired human femora. After broaching, the femoral canal was lavaged with 1 l saline. The specimens were embedded in plastic pots, bone cement was applied in a retrograde manner and cement was pressurized using a standard pressure protocol with a constant force of 3,000 N. Horizontal sections were obtained at predefined levels using an automatic saw. Microradiographs were taken and analysed using image analysis to assess the extent of cement penetration.

There were no significant differences in cement penetration into cancellous bone using the different jet-lavage systems. This technique is of great importance for obtaining a good interdigitation with cancellous bone. The different jet-lavage systems investigated in our study, however, seemed to be equally effective.

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Literatur

  1. Askew MJ, Steege JW, Lewis JL et al. (1984) Effect of cement pressure and bone strength on polymethylmethacrylate fixation. J Orthop Res 1: 412–420

    Article  PubMed  Google Scholar 

  2. Ballard WT, Callaghan JJ, Sullivan PM, Johnston RC (1994) The results of improved cementing techniques for total hip arthroplasty in patients less than fifty years old. J Bone Joint Surg 76-A: 959–964

    Google Scholar 

  3. Bannister GC, Miles AW (1988) The influence of cementing technique and blood on the strength of the bone-cement interface. Eng Med 17: 131–133

    PubMed  Google Scholar 

  4. Barrack RL, Mulroy RD, Harris WH (1992) Improved cementing techniques and femoral component loosening in young patients with hip arthroplasty. J Bone Joint Surg 74-B: 385–389

    Google Scholar 

  5. Beckenbaugh RD, Ilstrup DM (1978) Total hip arthroplasty. A review of three hundred and thirty-three cases with long follow-up. J Bone Joint Surg Am 60: 306–313

    PubMed  Google Scholar 

  6. Breusch SJ, Schneider U, Reitzel T, Kreutzer J et al. (2001) Die Bedeutung der Jet-Lavage für das In-vitro- und In-vivo- Zementierergebnis. Z Orthop 139: 52–63

    Article  PubMed  Google Scholar 

  7. Breusch SJ, Norman TL, Schneider U et al. (2000) Lavage technique in THA: Jet- lavage produces better cement penetration than syringe-lavage in the proximal femur. J Arthroplasty 15(7): 921–927

    Article  PubMed  Google Scholar 

  8. Breusch SJ, Schneider U, Kreutzer J et al. (2000) Einfluss der Zementiertechnik auf das Zementierergebnis am coxalen Femurende. Orthopäde 29: 260–270

    Google Scholar 

  9. Britton AR, Murray DW, Bulstrode CJ, McPherson K, Denham RA (1996) Long-term comparison of Charnley and Stanmore design total hip replacements. J Bone Joint Surg 78-B: 802–808

    Google Scholar 

  10. Byrick RJ, Bell RS, Kay JC et al. (1989) High-volume, high pressure pulsatile lavage during cemented arthoplasty. J Bone Joint Surg 71-A: 1331–1336

    Google Scholar 

  11. Christie J, Robinson CM, Singer B, Ray DC (1995) Medullary lavage reduces embolic phenomena and cardiopulmonary changes during cemented hemiarthroplasty. J Bone Joint Surg 77-B: 456–459

    Google Scholar 

  12. Draenert K (1988) Zur Praxis der Zementverankerung. Forschung und Fortbildung in der Chirurgie des Bewegungsapparates 2, Farbatlas. Art and Science, München

  13. Halawa M, Lee AJ, Ling RS, Vangala SS (1978) The shear strength of trabecular bone from the femur, and some factors affecting the shear strength of the cement-bone interface. Arch Orthop Trauma Surg 92: 19–30

    Article  PubMed  Google Scholar 

  14. Hashemi-Nejad A, Goddard NJ, Birch NC (1994) Current attitudes to cementing techniques in British hip surgery. Ann R Coll Surg Engl 76: 396–400

    PubMed  Google Scholar 

  15. Heisel C, Clarius M, Schneider U, Breusch SJ (2001) Thromboembolische Komplikationen bei der Verwendung von Knochenzement in der Hüftendoprothetik – Pathogenese und Prophylaxe. Z Orthop 139: 221–228

    Article  PubMed  Google Scholar 

  16. Krause W, Krug W. Miller JE (1982) Strength of the cement-bone interface. Clin Orthop 163: 290–299

    PubMed  Google Scholar 

  17. Lange DR (1979) The mechanical bonding of methylmethacrylate to cancellous bone. Effect of a hemostatic agent. J Bone Joint Surg Am 61(2): 254–256

    PubMed  Google Scholar 

  18. Maistrelli GL, Antonelli L, Fornasier V, Mahomed N (1995) Cement penetration with pulsed lavage versus syringe lavage in total knee arthroplasty. Clin Orthop 312: 261–265

    PubMed  Google Scholar 

  19. Majkowski RS, Miles AW, Bannister GC, Perkins J, Taylor GJ (1993) Bone surface preparation in cemented joint replacement. J Bone Joint Surg 75-B: 459–463

    Google Scholar 

  20. Malchau H, Herberts P (1998) Prognosis of total hip replacement in Sweden: Revision and re-revision rate in THR. Presented at the 65th Annual Meeting of the American Academy of Orthopaedic Surgeons, New Orleans

    Google Scholar 

  21. Markolf KL, Amstutz HC (1976) In vitro measurement of bone-acrylic interface pressure during femoral component insertion. Clin Orthop 121: 60–66

    PubMed  Google Scholar 

  22. McCaskie AW, Barnes MR, Lin E et al. (1997) Cement pressurisation during hip replacement. J Bone Joint Surg 79-B: 379–384

    Google Scholar 

  23. Noble PC, Espley AJ (1982) Examination of the influence of surgical technique upon the adequacy of cement fixation in the femur. J Bone Joint Surg 64-B: 120–121

    Google Scholar 

  24. Pitto RP, Koessler M, Draenert K (1998) The John Charnley Award: Prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty. Clin Orthop 355: 23–34

    Article  PubMed  Google Scholar 

  25. Roberts DW, Poss R, Kelley K (1986) Radiographic comparison of cementing techniques in total hip arthroplasty. J Arthroplasty 1: 241–247

    PubMed  Google Scholar 

  26. Savage AP, Revie IC, Orr JF (1993) Pressure measurement in bone cement around hip replacement stems. Innov Technol Biol Méd 14/4

  27. Sherman RM, Byrick RJ, Kay JC et al. (1983) The role of lavage in preventing hemodynamic and blood-gas changes during cemented arthroplasty. J Bone Joint Surg 65-A: 500–506

    Google Scholar 

  28. Song Y, Goodman SB, Jaffe RA (1994) An in vitro study of femoral intramedullary pressures during hip replacement using modern cement technique. Clin Orthop 302: 297–304

    PubMed  Google Scholar 

  29. Sutherland CJ, Wilde AH, Borden LS, Marks KE (1982) A ten-year follow-up of one hundred consecutive Müller curved-stem total hip-replacement arthroplasties. J Bone Joint Surg Am 64(7): 970–982

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Medizinische Universitätsklinik Heidelberg I, Im Neuenheimer Feld 410, 69120, Heidelberg

    C.-R. Becker

  2. Stiftung Orthopädische Universitätsklinik, Heidelberg

    B. Lehner

  3. Hals-Nasen-Ohrenklinik des Universitätsklinikums Heidelberg

    S. Ungethüm

  4. Department of Orthopaedics, University of Edinburgh, Scotland

    S. J. Breusch

Authors
  1. C.-R. Becker
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  2. B. Lehner
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  3. S. Ungethüm
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  4. S. J. Breusch
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Correspondence to C.-R. Becker.

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Becker, CR., Lehner, B., Ungethüm, S. et al. Der Einfluss des Jet-Lavage-Systems auf das In-vitro-Zementierergebnis. Orthopäde 35, 558–565 (2006). https://doi.org/10.1007/s00132-006-0932-z

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