How Much Sterile Saline Should be Used for Efficient Lavage During Total Knee Arthroplasty? Effects of Pulse Lavage Irrigation on Removal of Bone and Cement Debris

Yasuo Niki, Hideo Matsumoto, Toshiro Otani, Taisuke Tomatsu, Yoshiaki Toyama

Research output: Contribution to journalArticle

29 Citations (Scopus)


Bone and polymethyl methacrylate (PMMA) debris particles generated during total knee arthroplasty (TKA) reportedly cause third-body wear. The present study investigated the volume of pulse lavage sufficient for removal of intraoperative PMMA and bone particles. Subjects comprised 8 patients who underwent cemented TKA. Pulse lavage with 8 L of sterile saline was performed using a pulsatile irrigator. During pulse lavage, aspirated fluid was collected in a 1-L aliquot, and the number and size of bone and PMMA particles in each fluid were measured. Image analysis revealed that the number of particles peaked at first lavage and gradually decreased until eighth lavage. Significant differences were found between the first vs second, second vs third, and third vs fourth lavage. However, no significant differences were found beyond the fourth lavage. This study indicated that 4 L of pulse lavage is effective for removing the particles during cemented TKA.

Original languageEnglish
Pages (from-to)95-99
Number of pages5
JournalJournal of Arthroplasty
Issue number1
Publication statusPublished - 2007 Jan 1



  • cement debris
  • pulse lavage
  • third-body wear
  • total knee arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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