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General Orthopaedics

CEMENTING WITH A HEATSINK: A BOVINE MODEL

Combined Services Orthopaedic Society (CSOS)



Abstract

Bone cement reaches high temperatures while polymerising. Bone has been shown to be sensitive to thermal injury with osteonecrosis reported after one minute at 47°C. Necrosis during cementing might compromise the bone-cement interface. Some surgeons fill the joint cavity with irrigation fluid to provide a heatsink during cementing, but this has not been supported by research.

We used a model acetabulum in a bovine humerus to allow measurement of bone temperatures in cementing. Models were prepared with a 50mm diameter acetabulum and three temperature probe holes. Four warmed models were cemented with Palacos RG using a standard mixing system and a 10mm UMHWPE 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 highest temperature rise was 7.5°C. In the models with a heatsink, there was a mean fall of 4.4°C.

These results suggest that using a heatsink while cementing prostheses may reduce the peak bone temperature.