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Bone temperature during cementation with a heatsink: a bovine model pilot study.

Spurrier E, Payton O, Latimer M - BMC Res Notes (2014)

Bottom Line: Bone cement is an effective means of supporting implants, but reaches high temperatures while undergoing polymerisation.The mean temperature rise was 10.9°C.These results suggest that using a heatsink while cementing prostheses may reduce the peak bone temperature.

View Article: PubMed Central - HTML - PubMed

Affiliation: Peterborough City Hospital, Bretton Gate, Peterborough PE3 9GZ, UK. edward@edspurrier.co.uk.

ABSTRACT

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.

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Related in: MedlinePlus

Wet bone model showing implant and probes during cementation.
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Figure 1: Wet bone model showing implant and probes during cementation.

Mentions: The technique of filling a joint cavity with saline is applicable to cementing knee components as well as the acetabular and femoral components in hip arthroplasty. An acetabular model was chosen as it was felt it would be easiest to reproduce reliably.Four bovine humeri were obtained. Their proximal articular surfaces were drilled with a 50 mm hole saw to the maximum depth of the hole saw. A cylindrical hole was formed with an identical depth in each case to form a simple model acetabulum. Three temperature probe holes were drilled: one as close as possible to the acetabulum and to the same depth as the acetabulum; one as close as possible to the acetabulum and to half its depth; and one 10 mm away from the acetabulum and to half its depth. A 50 mm diameter, 10 mm thick disc of ultra-high molecular weight polyethylene (UMHWPE) was used to represent the acetabular bearing component. The experimental arrangement is shown at Figure 1.


Bone temperature during cementation with a heatsink: a bovine model pilot study.

Spurrier E, Payton O, Latimer M - BMC Res Notes (2014)

Wet bone model showing implant and probes during cementation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4126909&req=5

Figure 1: Wet bone model showing implant and probes during cementation.
Mentions: The technique of filling a joint cavity with saline is applicable to cementing knee components as well as the acetabular and femoral components in hip arthroplasty. An acetabular model was chosen as it was felt it would be easiest to reproduce reliably.Four bovine humeri were obtained. Their proximal articular surfaces were drilled with a 50 mm hole saw to the maximum depth of the hole saw. A cylindrical hole was formed with an identical depth in each case to form a simple model acetabulum. Three temperature probe holes were drilled: one as close as possible to the acetabulum and to the same depth as the acetabulum; one as close as possible to the acetabulum and to half its depth; and one 10 mm away from the acetabulum and to half its depth. A 50 mm diameter, 10 mm thick disc of ultra-high molecular weight polyethylene (UMHWPE) was used to represent the acetabular bearing component. The experimental arrangement is shown at Figure 1.

Bottom Line: Bone cement is an effective means of supporting implants, but reaches high temperatures while undergoing polymerisation.The mean temperature rise was 10.9°C.These results suggest that using a heatsink while cementing prostheses may reduce the peak bone temperature.

View Article: PubMed Central - HTML - PubMed

Affiliation: Peterborough City Hospital, Bretton Gate, Peterborough PE3 9GZ, UK. edward@edspurrier.co.uk.

ABSTRACT

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.

Show MeSH
Related in: MedlinePlus