Journal ArticleDOI
High-volume, high-pressure pulsatile lavage during cemented arthroplasty.
TLDR
It is concluded that meticulous high-volume, high-pressure pulsatile lavage reduces both pulmonary physiological derangements and fat emboli during bilateral cemented arthroplasty in dogs.Abstract:
To determine the efficacy of high-volume, high-pressure pulsatile lavage in the prevention of cardiopulmonary dysfunction and fat embolism during cemented arthroplasty, we studied twenty-eight mongrel dogs that had had a bilateral cemented arthroplasty. Significant increases in pulmonary-artery pressure and pulmonary vascular resistance, accompanied by decreases in arterial oxygen tension and increases in intrapulmonary shunt fraction (Qs/Qt), characterized cardiopulmonary dysfunction after bilateral cemented arthroplasty when no lavage was used. Low-volume, low-pressure manual lavage did not significantly alter these physiological changes, but there was a significant reduction in the number of fat emboli that were demonstrated in the lungs as compared with the no-lavage group. High-volume, high-pressure pulsatile lavage of the intramedullary cavity after reaming significantly reduced the changes in pulmonary-artery pressure, pulmonary vascular resistance, arterial oxygen tension, and intrapulmonary shunt fraction (Qs/Qt). In the pulsatile-lavage group, the number of fat microemboli that were found in the lungs was reduced to 25.7 per cent of those found in the no-lavage group. We concluded that meticulous high-volume, high-pressure pulsatile lavage reduces both pulmonary physiological derangements and fat emboli during bilateral cemented arthroplasty in dogs.read more
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Journal ArticleDOI
Bone cement implantation syndrome
TL;DR: It is possible to identify high risk groups of patients in which avoidable morbidity and mortality may be minimized by surgical selection for uncemented arthroplasty, and Invasive anaesthetic monitoring should be considered during cemented arthroPLasty in high risk patients.
Journal ArticleDOI
Sudden Death During Primary Hip Arthroplasty
TL;DR: Modifications of the operative techniques designed to minimize intramedullary hypertension were associated with a reduction greater than three-fold in overall intraoperative mortality rate and changes in surgical technique should be considered when cement fixation is used in patients thought to be at risk for having cardiopulmonary disturbances develop from venous embolization of marrow contents.
Journal ArticleDOI
Radiolucency at the Bone-Cement Interface in Total Knee Replacement. The Effects of Bone-Surface Preparation and Cement Technique.
TL;DR: It is demonstrated that proper preparation of the cancellous bone and pressurization of the cement reduce the initial occurrence of a radiolucent line, which may have a positive effect on the ultimate failure of at least the tibial component.
Journal ArticleDOI
Cemented Versus Noncemented Total Hip Arthroplasty—Embolism, Hemodynamics, and Intrapulmonary Shunting
Mark H. Ereth,Joseph G. Weber,Martin D. Abel,Robert L. Lennon,David G. Lewallen,Duane M. Ilstrup,Kai Rehder +6 more
TL;DR: Embolization was significantly greater after insertion of the prosthesis in patients undergoing cemented than in those undergoing noncemented THA, and intraoperative monitoring for embolism may help physicians assess patients in whom cardiorespiratory function deteriorates during THA.
Journal ArticleDOI
Cardiac arrest during hip arthroplasty with a cemented long-stem component. A report of seven cases.
TL;DR: Hip arthroplasty with a long-stem femoral component is associated with substantial risk in these patients, and excessive pressurization of cement should be avoided, and invasive hemodynamic monitoring should be used when the described conditions are present.