A New Approach for the Cleaning and Preparation of Bony Surfaces in Cemented Total Joint Arthroplasty

H.M. Reynolds, MD

The problem of aseptic loosening after cemented joint arthroplasty has spurred the evolution of modern cementing techniques, which have been developed to improve implant longevity by increasing cement penetration into the interstices of cancellous bone and by achieving a clean, dry interface between cement and bone. It is believed that residual fluid and fatty material results in higher hydrostatic pressure within the cancellous bone during cementation, thereby resisting penetration of cement.

 

 

 

In addition, removal of fat globules and marrow particulates from bone surfaces prior to pressurization and cementation of prosthetic components has been shown to reduce the number and size of embolic particles, thus potentially reducing the risk of developing cardiopulmonary and cognitive impairment following surgery.

 

 

 

In this VJO presentation, the late H.M. “Mac” Reynolds, MD, of Oakland, California demonstrates his technique of using carbon dioxide lavage after pulsed saline irrigation and suction during total joint arthroplasty in order to achieve superior cement penetration when compared to pulsed saline irrigation alone.

Specifications
  • Total Run Time: 19:41 minutes
  • Catalog Number: 2021
  • VJO Publication Date: March, 2002