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The thermal effects of lavage on 57 ox femoral heads prepared for hip resurfacing arthroplasty.

Baker RP, Whitehouse MR, Maclean A, Blom AW, Bannister GC - Acta Orthop (2013)

Bottom Line: We measured the effects of cooling with water at room temperature and with ice-cooled water.Blunting of the reamer was not found to have a statistically significant effect in this study.Cooling with ice-cooled water is recommended.

View Article: PubMed Central - PubMed

Affiliation: The Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.

ABSTRACT

Background and purpose: Previously, we have documented surface temperatures recorded by thermography great enough to cause osteonecrosis of the femoral head during hip resurfacing. We now performed an in vitro investigation with 3 questions: (1) whether water irrigation reduced bone surface temperature, (2) whether external bone temperatures were similar to core temperatures, and (3) whether blunting of the reamer affected temperature generation.

Methods: Using an ox-bone model, 57 femoral heads were peripherally reamed. The surface temperatures of bone were measured using a thermal camera and internal bone temperatures were measured using 2 theromocouples. We measured the effects of cooling with water at room temperature and with ice-cooled water. Progressive blunting of reamers was assessed over the 57 experiments.

Results: Mean and maximum temperatures generated during peripheral reaming were greater when no irrigation was used. Ice-cold saline protected femoral heads from thermal damage. External bone temperatures were much greater than internal temperatures, which were not sufficiently elevated to cause osteonecrosis regardless of lavage. Blunting of the reamer was not found to have a statistically significant effect in this study.

Interpretation: Cooling with ice-cooled water is recommended. Internal bone temperatures are not elevated despite the high surface temperatures reached during femoral head resurfacing.

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Related in: MedlinePlus

Maximum temperatures recorded from thermal camera.
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Figure 2: Maximum temperatures recorded from thermal camera.

Mentions: 52 full sets of data were available for analysis (18 in each of groups 1 and 2, and 16 in group 3). The mean maximum temperatures generated were 79°C (SD 18) in group 1, 58°C (SD 15) in group 2, and 37°C (SD 7.0) in group 3 (Figure 2). ANOVA revealed significant differences between the groups (p ≤ 0.001). Both group 2 (p = 0.001) and group 3 (p < 0.001) had significantly lower temperatures than group 1. Group 3 had significantly lower temperatures than group 2 (p < 0.001).


The thermal effects of lavage on 57 ox femoral heads prepared for hip resurfacing arthroplasty.

Baker RP, Whitehouse MR, Maclean A, Blom AW, Bannister GC - Acta Orthop (2013)

Maximum temperatures recorded from thermal camera.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3822128&req=5

Figure 2: Maximum temperatures recorded from thermal camera.
Mentions: 52 full sets of data were available for analysis (18 in each of groups 1 and 2, and 16 in group 3). The mean maximum temperatures generated were 79°C (SD 18) in group 1, 58°C (SD 15) in group 2, and 37°C (SD 7.0) in group 3 (Figure 2). ANOVA revealed significant differences between the groups (p ≤ 0.001). Both group 2 (p = 0.001) and group 3 (p < 0.001) had significantly lower temperatures than group 1. Group 3 had significantly lower temperatures than group 2 (p < 0.001).

Bottom Line: We measured the effects of cooling with water at room temperature and with ice-cooled water.Blunting of the reamer was not found to have a statistically significant effect in this study.Cooling with ice-cooled water is recommended.

View Article: PubMed Central - PubMed

Affiliation: The Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.

ABSTRACT

Background and purpose: Previously, we have documented surface temperatures recorded by thermography great enough to cause osteonecrosis of the femoral head during hip resurfacing. We now performed an in vitro investigation with 3 questions: (1) whether water irrigation reduced bone surface temperature, (2) whether external bone temperatures were similar to core temperatures, and (3) whether blunting of the reamer affected temperature generation.

Methods: Using an ox-bone model, 57 femoral heads were peripherally reamed. The surface temperatures of bone were measured using a thermal camera and internal bone temperatures were measured using 2 theromocouples. We measured the effects of cooling with water at room temperature and with ice-cooled water. Progressive blunting of reamers was assessed over the 57 experiments.

Results: Mean and maximum temperatures generated during peripheral reaming were greater when no irrigation was used. Ice-cold saline protected femoral heads from thermal damage. External bone temperatures were much greater than internal temperatures, which were not sufficiently elevated to cause osteonecrosis regardless of lavage. Blunting of the reamer was not found to have a statistically significant effect in this study.

Interpretation: Cooling with ice-cooled water is recommended. Internal bone temperatures are not elevated despite the high surface temperatures reached during femoral head resurfacing.

Show MeSH
Related in: MedlinePlus