Reduction of fat embolic risks in total hip arthroplasty using cannulated awls and rasps for the preparation of the femoral canal

Fat embolic phenomena during cemented and non-cemented total hip arthroplas ty occur even during the preparation of the femoral canal. This should be a voided in order to reduce the rate of fat embolic syndrome. In the present prospective study we demonstrate the benefit of cannulated awls and rasps i n the reduction of fat embolic phenomena by means of transoesophageal echoc ardiography and extended cardiopulmonary monitoring. Two groups of 5 patien ts each with identical surgical procedures were treated either with cannula ted (group 1) or with closed (group 2) awls and rasps. In group I no macroe mboli but three embolic showers grades 1 and 2 were seen. In contrast to th ese findings, three macroemboli and four embolic showers grades 1 and 3 wer e demonstrated in group 2. We recommend cannulated awls and rasps for the p reparation of the femoral canal in cemented and non-cemented total hip arth roplasty. They are a simple and inexpensive aid to avoid fat embolic syndro me.