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Pulsed lavage reduces the incidence of radiolucent lines under the tibial tray of Oxford unicompartmental knee arthroplasty

Pulsed lavage versus syringe lavage

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Abstract

The aim of the study was to determine whether the incidence of radiolucencies can be reduced using pulsed lavage before cementing the tibia in unicompartmental knee arthroplasty (UKA). We prospectively studied a consecutive series of 112 cemented Oxford UKA in 100 patients in two centres. In group A (n = 56) pulsed lavage and in group B (n = 56) conventional syringe lavage was used to clean the cancellous bone. The same standardised cementing technique was applied in all cases. At a minimum follow-up of one year patients were evaluated clinically and screened radiographs were obtained. The cement bone interface under the tibial plateau was divided into four zones and evaluated for the presence of radiolucent lines. All radiographs were evaluated (n = 112), and radiolucencies in all four zones were found in two cases in group A (4%) and in 12 cases in group B (22%) (p = 0.0149). Cement penetration showed a median of 2.6 mm (group A) and 1.5 mm (group B) (p < 0.0001). We recommend the routine use of pulsed lavage in Oxford UKA to reduce the incidence of radiolucency and to improve long-term fixation.

Résumé

Le but de cette étude est de déterminer les possibilités de réduction de l’incidence des liserés en utilisant un lavage pulsé avant la cimentation du tibia dans les prothèses unicompartimentales du genou (UKA). Nous avons réalisé une étude prospective consécutive de 112 prothèses (UKA) chez 100 patients, interventions réalisées dans deux centres. Dans le groupe A (n = 56): utilisation d’un lavage pulsé et dans le groupe B (n = 56): lavage conventionnel à la seringue de façon à nettoyer l’os spongieux. La même technique standardisée de cimentation a été utilisée dans tous les cas. Après un suivi minimum d’un an, les patients ont été évalués cliniquement et radiographiquement. L’interface os/ciment sous le plateau tibial a été divisé en 4 zones pour mieux analyser la présence des liserés. Toutes les radiographies ont été analysées (n = 112) et les liserés dans les 4 zones ont été trouvés dans deux cas, dans le groupe A (4%) et dans le groupe B (22%) (p = 0,0149). La pénétration médiane du ciment dans le groupe A est de 2,6 mm et dans le groupe B de 1,5 mm (p < 0,0001). Nous recommandons donc, en routine, l’utilisation d’un lavage pulsé de façon à réduire l’incidence des liserés et améliorer la fixation à long terme dans la mise en place des prothèses uni-compartimentales de type Oxford.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Orthopädische Universitätsklinik, University of Heidelberg, Heidelberg, Germany

    Michael Clarius, Christian Hauck, Joern B. Seeger & Peter R. Aldinger

  2. Nuffield Orthopaedic Centre, Oxford, UK

    Andrew James & David W. Murray

  3. Orthopädische Universitätsklinik Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany

    Peter R. Aldinger

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  1. Michael Clarius
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  2. Christian Hauck
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  3. Joern B. Seeger
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  4. Andrew James
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  6. Peter R. Aldinger
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Correspondence to Peter R. Aldinger.

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Clarius, M., Hauck, C., Seeger, J.B. et al. Pulsed lavage reduces the incidence of radiolucent lines under the tibial tray of Oxford unicompartmental knee arthroplasty. International Orthopaedics (SICOT) 33, 1585–1590 (2009). https://doi.org/10.1007/s00264-009-0736-y

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  • DOI: https://doi.org/10.1007/s00264-009-0736-y

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