Lavage technique in total hip arthroplasty - Jet lavage produces better cement penetration than syringe lavage in the proximal femur

Sixteen paired human cadaver femora were prepared using conventional broach es. Cancellous bone was irrigated with 1 L pulsed lavage in one femur and 1 L syringe lavage in the contralateral femur. The specimens were embedded i n specially designed pots, and vacuum-mixed bone-cements were applied in a retrograde manner. After application of a standard pressure to the pots, th e femora were removed and radiographed, and horizontal sections were obtain ed and analyzed to assess cement penetration into cancellous bone and the r atio of the area of supported to unsupported cancellous bone (Rcb). Our res ults show that in equal quality bone, the use of jet lavage yields signific antly (P < .0001) improved cement penetration and Rcb compared with syringe lavage specimens. Jet lavage should be considered routine to achieve inter digitation with cancellous bone in cemented total hip arthroplasty.