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October 1, 1989Journal of Bone and Joint Surgery

High-volume, high-pressure pulsatile lavage during cemented arthroplasty.

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Key result

High-volume, high-pressure pulsatile lavage during bilateral cemented arthroplasty in dogs significantly reduced pulmonary physiological derangements and reduced fat microemboli to 25.7% of the no-lavage group.

Why the study?

Does high-volume, high-pressure pulsatile lavage prevent cardiopulmonary dysfunction and fat embolism in dogs undergoing bilateral cemented arthroplasty?

Population

28 mongrel dogs undergoing bilateral cemented arthroplasty

Comparison

High-volume, high-pressure pulsatile lavage of… vs No lavage and low-volume, low-pressure manual…

Design

Preclinical

Authors

RBR. ByrickSunnybrook Health Science CentreRBR. S. BellPrincess Alexandra HospitalJKJ. KayWestern University

Discussion

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Implication

Provides preclinical support in dogs; leaves open translation to human cemented arthroplasty and cardiopulmonary outcomes.

Structured PICO

Does high-volume, high-pressure pulsatile lavage prevent cardiopulmonary dysfunction and fat embolism in dogs undergoing bilateral cemented arthroplasty?

P
Population
28 mongrel dogs undergoing bilateral cemented arthroplasty.
I
Intervention
High-volume, high-pressure pulsatile lavage of the intramedullary cavity after reaming
C
Comparator
No lavage and low-volume, low-pressure manual lavage
O
Outcome
Cardiopulmonary dysfunction (pulmonary-artery pressure, pulmonary vascular resistance, arterial oxygen tension, intrapulmonary shunt fraction) and fat embolismsurrogate

High-volume, high-pressure pulsatile lavage effectively reduces pulmonary physiological derangements and fat emboli during cemented arthroplasty in a canine model.

Cite This Study

Byrick et al. (1989) studied Cardiopulmonary dysfunction and fat embolism during cemented arthroplasty (n=28). High-volume, high-pressure pulsatile lavage vs. No lavage and low-volume, low-pressure manual lavage was evaluated on Cardiopulmonary dysfunction and fat embolism. High-volume, high-pressure pulsatile lavage during bilateral cemented arthroplasty in dogs significantly reduced pulmonary physiological derangements and reduced fat microemboli to 25.7% of the no-lavage group.

synapsesocial.com/papers/6a9bd16b0b073dbbe4b20ddahttps://doi.org/10.2106/00004623-198971090-00008
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hypotension during cemented arthroplasty. Relationship to cardiac output and fat embolism1993 · 88 citations
  2. 2Medullary lavage reduces embolic phenomena and cardiopulmonary changes during cemented hemiarthroplasty1995 · 76 citations
  3. 3Pulmonary haemodynamics and right ventricular function in cemented vs uncemented total hip arthroplasty—A randomized trial2018 · 26 citations
  4. 4Intramedullary Pressure and Pulmonary Embolism of Femoral Medullary Contents in Dogs during Insertion of Bone Cement and a Prosthesis1974 · 139 citations
  5. 5Perioperative Pulmonary Circulatory Changes During Bilateral Total Hip Arthroplasty Under Regional Anesthesia2010 · 37 citations