An experimental model was designed to investigate the role of meticulous
intramedullary lavage in the prevention of the blood-gas and hemodynamic
changes that have been documented to occur during cemented arthroplasty.
Twenty-one adult mongrel dogs were divided into two groups. One group had
the medullary canal thoroughly lavaged prior to insertion of the cement and
prosthesis and the other group had no lavage. The results clearly showed
that careful lavage can eliminate the significant decreases in arterial PO2
and increases in intrapulmonary shunt fraction and pulmonary artery
pressure that were evident in the group that did not have lavage. Femoral
medullary reaming was investigated and was shown not to compromise the
dogs' cardiopulmonary status. Clinical Relevance: During cemented
arthroplasty, thorough lavage of a plugged medullary canal prior to
insertion of the cement and prosthesis is a highly effective prophylactic
measure in the elimination of gas-exchange and hemodynamic
complications.