Effect of cementing technique and cement type on thermal necrosis in hip resurfacing arthroplasty--a numerical study. 2012

Dennis Janssen, and Priyanka Srinivasan, and Thierry Scheerlinck, and Nico Verdonschot
Orthopaedic Research Laboratory, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, the Netherlands. d.janssen@orthop.umcn.nl

Femoral fractures within resurfacing implants have been associated with bone necrosis, possibly resulting from heat generated by cement polymerization. The amount of heat generated depends on cement mantle volume and type of cement. Using finite element analysis, the effect of cement type and volume on thermal necrosis was analyzed. Based on CT-data of earlier implantations, two different models were created: a thick mantle model, representing a low-viscosity "cement filling" technique, and a thin mantle model, representing a high viscosity "cement packing" technique. Six cement types were analyzed. The polymerization heat generation and its effect on bone necrosis were predicted. In the thin cement mantle models, no thermal necrosis was predicted. Thick cement mantle models produced thermal necrosis at the cement-bone interface depending on cement type. In the worst case, 6% of the bone at the cement-bone interface became necrotic, covering almost the entire cross-sectional area. The current findings suggest a potential thermal drawback of thick cement mantles, although it is unclear whether thermal bone necrosis significantly affects implant fixation or increases the fracture risk. Furthermore, our study showed distinct differences between the heat generated and resulting thermal damage caused by the various cement types.

UI MeSH Term Description Entries
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D010020 Osteonecrosis Death of a bone or part of a bone, either atraumatic or posttraumatic. Aseptic Necrosis of Bone,Avascular Necrosis of Bone,Kienbock Disease,Necrosis, Aseptic, of Bone,Necrosis, Avascular, of Bone,Bone Necrosis,Kienbock's Disease,Kienboeck Disease,Kienboeck's Disease,Bone Aseptic Necrosis,Bone Avascular Necrosis,Bone Necroses,Kienboecks Disease,Necroses, Bone,Necrosis, Bone,Osteonecroses
D001843 Bone Cements Adhesives used to fix prosthetic devices to bones and to cement bone to bone in difficult fractures. Synthetic resins are commonly used as cements. A mixture of monocalcium phosphate, monohydrate, alpha-tricalcium phosphate, and calcium carbonate with a sodium phosphate solution is also a useful bone paste. Bone Cement,Bone Glues,Bone Pastes,Bone Glue,Bone Paste,Cement, Bone,Cements, Bone,Glue, Bone,Glues, Bone,Paste, Bone,Pastes, Bone
D006358 Hot Temperature Presence of warmth or heat or a temperature notably higher than an accustomed norm. Heat,Hot Temperatures,Temperature, Hot,Temperatures, Hot
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip
D001178 Arthroplasty Surgical reconstruction of a joint to relieve pain or restore motion. Bone Tunnel Enlargement,Bone Tunnel Widening,Arthroplasties,Bone Tunnel Enlargements,Bone Tunnel Widenings,Enlargement, Bone Tunnel,Tunnel Enlargement, Bone,Tunnel Widening, Bone,Widening, Bone Tunnel

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