Hydrogen peroxide in orthopaedic surgery – is it worth the risk?

Abstract

Hydrogen peroxide (H₂O₂) is commonly used in orthopaedic surgery during cemented arthroplasty and wound washouts. Its purported roles include antisepsis, haemostasis, mechanical debridement, and optimising the cement–bone interface during cementing. However, despite its apparent harmless mechanism of action, H₂O₂ has been implicated in fatal and near fatal complications caused through oxygen emboli. We present a case of oxygen embolism and review the existing literature to highlight its potential risks and its lack of therapeutic value. We believe there is little role for its use in orthopaedic surgery.

Keywords:

• Arthroplasty
• cement
• hydrogen peroxide
• oxygen embolism

Disclosure statement

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.