Suctioning prevents emboli during insertion of acetabular components without holes.

Abstract

Embolic events can occur when inserting uncemented press-fit acetabular components (cups), especially those without holes. However, there is a paucity of literature regarding prevention of embolic events. We asked whether suctioning in the acetabulum might be as effective as suctioning during femoral insertion. We compared embolic events in 30 hips (27 patients) (Group 1) that had conventional press-fit cup fixation without holes, with 30 hips (27 patients) (Group 2) treated by suctioning from a cannula in the ilium during cup impaction. We evaluated embolic events using transesophageal echocardiography, blood gas (PaO2, PaCO2), and blood pressure preoperatively and 5 minutes after cup placement. Echocardiography showed less severe embolic events in Group 2 (23%) than in Group 1 (100%). The decrease in rate of the PaO2 and the blood pressure from baseline to 5 minutes after cup placement were lower in Group 2 than in Group 1. Our data suggest the suctioning technique is effective to reduce embolic events by cup without holes which may cause intraoperative embolic complications.