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Cotton swabs used to dry the femoral canal prior to cementation leave behind particulate matter: a cadaveric experiment

Abstract

The aim of this study was to assess whether any particulate debris was left behind from the cotton swabs used to dry the femora prior to cementation, which in theory could cause a foreign body reaction and contribute to aseptic loosening of a hip replacement. A study was conducted on 8 femora from 4 cadavers. The surgical technique of performing a hip replacement using a posterior approach was simulated up to stage of cementing of the femoral prosthesis. Cotton swabs were used in 4 of the femora and femoral tampons were used in the other 4, to dry the femora after the intramedullary canals were lavaged with normal saline. Seven-inch segments of the proximal femora were then sawed off using a gigli saw and sent for pathological analysis. Particulate matter from the cotton swabs was found in the interstices of the proximal four inches of all the femora dried using cotton swabs. In comparison, in the femora dried using femoral tampons, no particulate matter was detected. The presence of cotton swabs in femora, which have been known to cause a foreign body reaction, could then in theory contribute to early aseptic loosening. This paper draws attention to this possibility and explores an alternative such as the use of a femoral tampon to dry the femur.

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Received: 2 April 2002, Accepted: 17 July 2002

Correspondence to: S. Sharma

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Sharma, S. Cotton swabs used to dry the femoral canal prior to cementation leave behind particulate matter: a cadaveric experiment. J Orthopaed Traumatol 4, 1–4 (2003). https://doi.org/10.1007/s101950300000

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  • Key words Cotton swabs
  • Femoral canal
  • Hip replacement
  • Particulate debris