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No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty : a randomised RSA study with 6 years follow-up

Zampelis, Vasileios LU ; Flivik, Gunnar LU and Kesteris, Uldis LU (2019) In HIP International
Abstract

Introduction: In contrast to cemented hip prostheses, the effect of washing the bone bed with jet-lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet-lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better-organised trabecular structure of new bone when jet-lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet-lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior... (More)

Introduction: In contrast to cemented hip prostheses, the effect of washing the bone bed with jet-lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet-lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better-organised trabecular structure of new bone when jet-lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet-lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior jet-lavage. Methods: 40 patients with primary osteoarthritis operated on with a cementless titanium grit blasted stem are included in the study. The patients were randomised to either jet-lavage or control without any lavage of the femoral canal prior to insertion of the prosthesis. The stem migration pattern was measured with RSA at 0, 3, 12, 24 and 72 months. Results: At 6 years, 19 patients remained for analysis in the jet-lavage and 18 in the control group. We found no difference in extent or pattern of migration as measured with RSA. Both groups seemed to have stabilised within 3 months after a slight subsidence and retroversion. No stem was revised or considered loose as measured with RSA. Conclusions: Washing the bone bed with jet-lavage prior to insertion of cementless stems does not affect the stability of cementless femoral components. No adverse effects were observed.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Cementless stem, lavage, primary hip arthroplasty
in
HIP International
publisher
Wichtig Editore
external identifiers
  • scopus:85064829670
ISSN
1120-7000
DOI
10.1177/1120700019843123
language
English
LU publication?
yes
id
6ed86f14-6ff6-4b8e-80a0-840e7235e7a8
date added to LUP
2019-05-08 13:21:27
date last changed
2019-05-28 03:58:15
@article{6ed86f14-6ff6-4b8e-80a0-840e7235e7a8,
  abstract     = {<p>Introduction: In contrast to cemented hip prostheses, the effect of washing the bone bed with jet-lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet-lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better-organised trabecular structure of new bone when jet-lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet-lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior jet-lavage. Methods: 40 patients with primary osteoarthritis operated on with a cementless titanium grit blasted stem are included in the study. The patients were randomised to either jet-lavage or control without any lavage of the femoral canal prior to insertion of the prosthesis. The stem migration pattern was measured with RSA at 0, 3, 12, 24 and 72 months. Results: At 6 years, 19 patients remained for analysis in the jet-lavage and 18 in the control group. We found no difference in extent or pattern of migration as measured with RSA. Both groups seemed to have stabilised within 3 months after a slight subsidence and retroversion. No stem was revised or considered loose as measured with RSA. Conclusions: Washing the bone bed with jet-lavage prior to insertion of cementless stems does not affect the stability of cementless femoral components. No adverse effects were observed.</p>},
  author       = {Zampelis, Vasileios and Flivik, Gunnar and Kesteris, Uldis},
  issn         = {1120-7000},
  keyword      = {Cementless stem,lavage,primary hip arthroplasty},
  language     = {eng},
  month        = {04},
  publisher    = {Wichtig Editore},
  series       = {HIP International},
  title        = {No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty : a randomised RSA study with 6 years follow-up},
  url          = {http://dx.doi.org/10.1177/1120700019843123},
  year         = {2019},
}