Pulse-lavage brushing followed by hydrogen peroxide-gauze packing for bone-bed preparation in cemented total hip arthroplasty: a bovine model.
OBJECTIVE
To compare the effectiveness of pulse-lavage brushing followed by hydrogen peroxide-gauze packing with either technique alone or normal-saline irrigation in bone-bed preparation for cemented total hip arthroplasty.


METHODS
44 fresh-frozen ox femoral canals were prepared for cemented total hip arthroplasty using 4 techniques: normal-saline irrigation, pulse-lavage brushing, hydrogen peroxide-soaked gauze packing, and a combination of the latter 2 techniques. The maximum tensile pull-out force required to separate the prosthesis from the femoral canal was measured as an indicator of the strength of the cement-bone interface.


RESULTS
The mean pull-out force to separate the prosthesis from the femoral canal was significantly higher in specimens prepared with pulse-lavage brushing followed by hydrogen peroxide-soaked gauze packing or pulse-lavage brushing alone than those prepared with normal-saline irrigation or hydrogen peroxide-soaked gauze packing alone (p<0.001).


CONCLUSIONS
Pulse-lavage brushing is more effective at cleansing the femoral canal and increasing mechanical strength at the cement-bone interface than preparation with normal-saline irrigation or hydrogen peroxide-soaked gauze packing.
Ackland
David C
DC
Department of Mechanical Engineering, University of Melbourne, Parkville, Victoria, Australia. dackland@unimelb.edu.au
Yap
Vincent
V
Ackland
Margaret L
ML
Williams
John F
JF
Hardidge
Andrew
A
de Steiger
Richard
R
D000704:Analysis of Variance; D000818:Animals; D019644:Arthroplasty, Replacement, Hip; D001458:Bandages; D001843:Bone Cements / Q000494:pharmacology*; D002417:Cattle; D006861:Hydrogen Peroxide / Q000494:pharmacology*; D066298:In Vitro Techniques; D023421:Models, Animal; D012965:Sodium Chloride / Q000494:pharmacology; D013499:Surface Properties; D013718:Tensile Strength; D007507:Therapeutic Irrigation / Q000379:methods*
D001843:Bone Cements; D012965:Sodium Chloride; D006861:Hydrogen Peroxide