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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXV | Pages 106 - 106
1 Jun 2012
The Effect of Cementing Technique on Polymerization Heat Generation and Thermal Necrosis in Hip Resurfacing Arthroplasty
Janssen D Srinivasan P Scheerlinck T Verdonschot N
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Introduction

Hip resurfacing arthroplasty has gained popularity as an alternative for total hip arthroplasty. Usually, cemented fixation is used for the femoral component. However, each type of resurfacing design has its own recommended cementing technique.

In a recent investigation the effect of various cementing techniques on cement mantle properties was studied. This study showed distinct differences in cement mantle volume, filling index and morphology.

In this study, we investigated the effect of these cement mantle variations on the heat generation during polymerization, and its consequences in terms of thermal bone necrosis.

Materials and methods

Two FEA models of resurfacing reconstructions were created based on CT-data of in vitroimplantations (Fig 1). The two models had distinct differences with respect to the amount of cement that was used for fixation. The first model was based on an implantation with low-viscosity cement, with anchoring holes drilled in the bone, and suction applied to maximize cement penetration. The second model was based on an implantation with medium viscosity cement smeared onto the bone, with no holes and no suction, leading to a thin cement layer.

Thermal analyses were performed of the polymerization process, simulating three different types of bone cement: Simplex P (Stryker), CMW3 (DePuy J&J) and Osteobond (Zimmer), with distinct differences in polymerization characteristics. The polymerization kinematics were based on data reported previously.

During the polymerization simulations the cement and bone temperature were monitored. Based on the local temperature and time of exposure, the occurrence of thermal bone necrosis was predicted. The total volume of necrotic bone was calculated for each case.