期刊论文详细信息
BMC Research Notes
Bone temperature during cementation with a heatsink: a bovine model pilot study
Mark Latimer1  Olivia Payton1  Edward Spurrier2 
[1] Peterborough City Hospital, Bretton Gate, Peterborough PE3 9GZ, UK;35b Marryat Square, Wyfold Road, London SW6 6UA, UK
关键词: Heatsink;    Osteonecrosis;    Bone cements;    Arthroplasty;   
Others  :  1131745
DOI  :  10.1186/1756-0500-7-494
 received in 2014-04-29, accepted in 2014-06-20,  发布年份 2014
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【 摘 要 】

Background

Bone cement is an effective means of supporting implants, but reaches high temperatures while undergoing polymerisation. Bone has been shown to be sensitive to thermal injury with osteonecrosis reported after one minute at 47°C. Necrosis during cementing may lead to loosening of the prosthesis. Some surgeons fill the joint cavity with cool irrigation fluid to provide a heatsink during cementing, but this has not been supported by research. This paper assesses a simple technique to investigate the efficacy of this method.

Findings

We used a model acetabulum in a bovine humerus to allow measurement of bone temperatures in cementing. Models were prepared with a 50 mm diameter acetabulum and three temperature probe holes; two as close as possible to the acetabular margin at half the depth of the acetabulum and at the full depth of the acetabulum, and one 10 mm from the acetabular rim. Four warmed models were cemented with Palacos RG using a standard mixing system and a 10 mm polyethylene disc to represent an acetabular component. Two of the acetabular models were filled with room temperature water to provide a heatsink. An electronic probe measured temperature at 5 second intervals from the moment of cementing.

In the models with no heatsink, peak temperature was 40.3°C. The mean temperature rise was 10.9°C. In the models with a heatsink, there was an average fall in the bone temperature during cementing of 4.4°C.

Conclusions

These results suggest that using a heatsink while cementing prostheses may reduce the peak bone temperature. This study demonstrates a simple, repeatable technique which may be useful for larger trials.

【 授权许可】

   
2014 Spurrier et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Whitehouse MR, Atwal NS, Pabbruwe M, Blom AW, Bannister GC: Osteonecrosis with the use of polymethylmethacrylate cement for hip replacement: thermal-induced damage evidenced in vivo by decreased osteocyte viability. European cells Mat 2014, 27:50-63.
  • [2]Mjoberg B: Loosening of the cemented hip prosthesis. The importance of heat injury. Acta Orthop Scand Suppl 1986, 221:1-40.
  • [3]Martens KA, Edwards SL, Omar IM, Saltzman MD: Heat generated with pegged or keeled glenoid components fixed with defined amounts of cement. Orthopedics 2012, 35(4):e469-e473.
  • [4]Eriksson RA, Albrektsson T, Magnusson B: Assessment of bone viability after heat trauma. A histological, histochemical and vital microscopic study in the rabbit. Scand J Plast Reconstr Surg 1984, 18(3):261-268.
  • [5]Hsieh PH, Tai CL, Liaw JW, Chang YH: Thermal damage potential during hip resurfacing in osteonecrosis of the femoral head: an experimental study. J Orthop Res Off Publ Orthop Res Soc 2008, 26(9):1206-1209.
  • [6]Urrutia J, Bono CM, Mery P, Rojas C: Early histologic changes following polymethylmethacrylate injection (vertebroplasty) in rabbit lumbar vertebrae. Spine (Phila Pa 1976) 2008, 33(8):877-882.
  • [7]Hsieh PH, Tai CL, Chang YH, Lee MS, Shih HN, Shih CH: Precooling of the femoral canal enhances shear strength at the cement-prosthesis interface and reduces the polymerization temperature. J Orthop Res Off Publ Orthop Res Soc 2006, 24(9):1809-1814.
  • [8]Gill HS, Campbell PA, Murray DW, De Smet KA: Reduction of the potential for thermal damage during hip resurfacing. J Bone Joint Surg British Vol 2007, 89(1):16-20.
  • [9]Eitenmuller J, Wolbert R, Eisen E: The effect of circulation on the polymerizing temperature of palacos. An experimental study (author’s transl). Arch Orthop Trauma Surg 1981, 98(1):61-67.
  • [10]Pearce CJ, Patel S, Sexton SA, Reeves A, Khairandish H, Khaleel A: The effect of isotonic saline on the strength of bone cement during the polymerisation period. Hip Int J Clinical Exper Res Hip Pathol Therap 2011, 21(2):238-242.
  • [11]McMahon S, Hawdon G, Bare J, Yu Y, Bertollo N, Walsh WR: In vivo response of bone defects filled with PMMA in an ovine model. Hip Int J Clinical Exp Res Hip Pathol Therap 2011, 21(5):616-622.
  • [12]Berman AT, Reid JS, Yanicko DR Jr, Sih GC, Zimmerman MR: Thermally induced bone necrosis in rabbits. Relation to implant failure in humans. Clin Orthop Relat Res 1984, 186:284-292.
  • [13]Krause M, Breer S, Hahn M, Ruther W, Morlock MM, Amling M, Zustin J: Cementation and interface analysis of early failure cases after hip-resurfacing arthroplasty. Int Orthop 2012, 36(7):1333-1340.
  • [14]Huang KY, Yan JJ, Lin RM: Histopathologic findings of retrieved specimens of vertebroplasty with polymethylmethacrylate cement: case control study. Spine (Phila Pa 1976) 2005, 30(19):E585-E588.
  • [15]Ingram JH, Kowalski R, Fisher J, Ingham E: The osteolytic response of macrophages to challenge with particles of simplex P, endurance, palacos R, and vertebroplastic bone cement particles in vitro. J Biomed Mater Res B Appl Biomater 2005, 75(1):210-220.
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