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 broaches. 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 in specially designed pots, and vacuum-mixed bone-cements were applied in a retrograde manner. After application of a standard pressure to the pots, the femora were removed and radiographed, and horizontal sections were obtained and analyzed to assess cement penetration into cancellous bone and the ratio of the area of supported to unsupported cancellous bone (Rcb). Our results show that in equal quality bone, the use of jet lavage yields significantly (P < .0001) improved cement penetration and Rcb compared with syringe lavage specimens. Jet lavage should be considered routine to achieve interdigitation with cancellous bone in cemented total hip arthroplasty.