Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty

Abstract Introduction In cemented total knee arthroplasty (TKA), pressurized carbon dioxide (CO2) lavage prior to cement fixation can eliminate debris at the bone-cement interface and is considered effective for increasing cement penetration and preventing aseptic loosening. Regarding the risk of a...

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Main Authors: Ryo Sasaki, Masaki Nagashima, Toshiro Otani, Yoshifumi Okada, Noriyuki Aibara, Kenichiro Takeshima, Ken Ishii
Format: Article
Language:English
Published: BMC 2022-07-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-022-03204-3
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author Ryo Sasaki
Masaki Nagashima
Toshiro Otani
Yoshifumi Okada
Noriyuki Aibara
Kenichiro Takeshima
Ken Ishii
author_facet Ryo Sasaki
Masaki Nagashima
Toshiro Otani
Yoshifumi Okada
Noriyuki Aibara
Kenichiro Takeshima
Ken Ishii
author_sort Ryo Sasaki
collection DOAJ
description Abstract Introduction In cemented total knee arthroplasty (TKA), pressurized carbon dioxide (CO2) lavage prior to cement fixation can eliminate debris at the bone-cement interface and is considered effective for increasing cement penetration and preventing aseptic loosening. Regarding the risk of a preliminary diagnosis of implant loosening, a radiolucent line (RLL) is a valuable sign. The purpose of this study was to compare the incidence of a tibial RLL at 2 years after TKA with and without pressurized CO2 lavage. Methods This is a retrospective study. One hundred knees from 98 patients were enrolled in this study. TKA was performed without pressurized CO2 lavage (CO2− group) for the first 47 knees, and with pressurized CO2 lavage (CO2+ group) for the next 53 knees. The depth of cement penetration was measured just after surgery, and the incidence of tibial RLL > 2 mm at 2 years after TKA was determined. Results Significant differences between groups were not seen regarding pre- and postoperative clinical factors. The depth of cement penetration in each area was significantly higher in the CO2+ group. The frequency of knees with RLL > 2 mm was significantly lower in the CO2+ group than in the CO2− group (p < 0.001). Conclusions Pressurized CO2 lavage improved cement penetration and decreased the incidence of tibial RLL > 2 mm at 2 years after TKA.
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spelling doaj.art-c96a6b0f7abe4f38ba3907b3a80012b42022-12-22T04:02:08ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2022-07-011711710.1186/s13018-022-03204-3Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplastyRyo Sasaki0Masaki Nagashima1Toshiro Otani2Yoshifumi Okada3Noriyuki Aibara4Kenichiro Takeshima5Ken Ishii6Department of Orthopaedic Surgery, School of Medicine, International University of Health and WelfareDepartment of Orthopaedic Surgery, School of Medicine, International University of Health and WelfareDepartment of Orthopaedic Surgery, International University of Health and Welfare Ichikawa HospitalDepartment of Orthopaedic Surgery, International University of Health and Welfare Mita HospitalDepartment of Orthopaedic Surgery, International University of Health and Welfare Mita HospitalDepartment of Orthopaedic Surgery, School of Medicine, International University of Health and WelfareDepartment of Orthopaedic Surgery, School of Medicine, International University of Health and WelfareAbstract Introduction In cemented total knee arthroplasty (TKA), pressurized carbon dioxide (CO2) lavage prior to cement fixation can eliminate debris at the bone-cement interface and is considered effective for increasing cement penetration and preventing aseptic loosening. Regarding the risk of a preliminary diagnosis of implant loosening, a radiolucent line (RLL) is a valuable sign. The purpose of this study was to compare the incidence of a tibial RLL at 2 years after TKA with and without pressurized CO2 lavage. Methods This is a retrospective study. One hundred knees from 98 patients were enrolled in this study. TKA was performed without pressurized CO2 lavage (CO2− group) for the first 47 knees, and with pressurized CO2 lavage (CO2+ group) for the next 53 knees. The depth of cement penetration was measured just after surgery, and the incidence of tibial RLL > 2 mm at 2 years after TKA was determined. Results Significant differences between groups were not seen regarding pre- and postoperative clinical factors. The depth of cement penetration in each area was significantly higher in the CO2+ group. The frequency of knees with RLL > 2 mm was significantly lower in the CO2+ group than in the CO2− group (p < 0.001). Conclusions Pressurized CO2 lavage improved cement penetration and decreased the incidence of tibial RLL > 2 mm at 2 years after TKA.https://doi.org/10.1186/s13018-022-03204-3Total knee arthroplastyPressurized carbon dioxide lavageRadiolucent lineAseptic loosening
spellingShingle Ryo Sasaki
Masaki Nagashima
Toshiro Otani
Yoshifumi Okada
Noriyuki Aibara
Kenichiro Takeshima
Ken Ishii
Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
Journal of Orthopaedic Surgery and Research
Total knee arthroplasty
Pressurized carbon dioxide lavage
Radiolucent line
Aseptic loosening
title Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
title_full Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
title_fullStr Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
title_full_unstemmed Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
title_short Pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
title_sort pressurized carbon dioxide lavage reduces the incidence of a radiolucent line around the tibial component two years after total knee arthroplasty
topic Total knee arthroplasty
Pressurized carbon dioxide lavage
Radiolucent line
Aseptic loosening
url https://doi.org/10.1186/s13018-022-03204-3
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