Biomet Cement and Cementing Systems

Bone bed preparation

Fat embolism

Cement pressurization causes a significant increase in intramedullary pressure (IMP). As consequence fat and bone marrow embolization may result. The close relationship between raised IMP and cardio-respiratory complications has been well established both experimentally and clinically. The rise of IMP has been recognized as the most pathopsysiological mechanism for the development of interoperative embolism.³

Apart from creating an effective means of intramedullary drainage, through lavage with removal of medullary contents prior to cement application is an important step to reduce the risk of fat and bone marrow extravasations.³

High pressure pulse lavage used repeatedly during the cleaning sequence prevents microembolisation of the marrow contents and significantly minimizes circulatory changes. The resulting removal of medullary content has been proven both experimentally and clinically to reduce risk of fat embolism. Not only the volume but also the quantity of bone lavage influence the risk of fat embolism.^4,5