Pre-heating of components in cemented total hip arthroplasty

A. A. Jafri, Sarah Green, P. F. Partington, A. W. McCaskie, S. D. Muller

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22 Citations (Scopus)

Abstract

Fatigue fractures which originate at stress-concentrating voids located at the implantcement interface are a potential cause of septic loosening of cemented femoral components. Heating of the component to 44degreesC is known to reduce the porosity of the cement-prosthesis interface. The temperature of the cement-bone interface was recorded intral-operatively as 32.3degreesC. A simulated femoral model was devised to study the effect of heating of the component on the implant-cement interface. Heating of the implant and vacuum mixing have a synergistic effect on the porosity of the implant-cement interface, and heating also reverses the gradients of microhardness in the mantle. Heating of the implant also reduces porosity at the interface depending on the temperature. A minimum difference in temperature between the implant and the bone of 3degreesC was required to produce this effect. The optimal difference was 7degreesC, representing a balance between maximal reduction of porosity and an increased risk of thermal injury. Using contemporary cementing techniques, heating the implant to 40degreesC is recommended to produce an optimum effect.
Original languageEnglish
JournalJournal of Bone and Joint Surgery, British Volume
DOIs
Publication statusPublished - Nov 2004

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