Analysis of lower extremity embolic material after total knee arthroplastyin a canine model

Emboli assumed to consist of fat, marrow, cement, and bone are generated du ring total knee arthroplasty. This study collected and identified the const ituents of the embolic debris and assessed the effects of intramedullary cu tting guides in a canine model. During cemented knee arthroplasties with or without the use of intramedullary guides, all embolic debris was collected in a single lobe of lung. in dogs using intramedullary guides, transesopha geal echocardiography revealed a sustained embolic shower, and histological ly marked amounts of emboli obstructed the pulmonary vasculature. The embol i were composed of fat cells and hematopoietic cells (marrow elements) inte rspersed with free fat globules. Marrow elements are the primary constituen ts of the emboli generated during total knee arthroplasty. Intramedullary g uides increased debris generation.