Thermomechanical method for cement extraction in revision arthroplasty

被引:0
作者
Ghanem M. [1 ]
Koenig A. [2 ]
Dehn F. [2 ]
Heyde C.-E. [1 ]
Josten C. [1 ]
机构
[1] Department of Orthopedic Surgery, Traumatology and Plastic Surgery, University Hospital of Leipzig, Liebigstrasse 20, Leipzig
[2] Faculty of Chemistry and Mineralogy, Professorship of Multifunctional Construction Materials, University of Leipzig, Leipzig
关键词
Bone cement extraction; Glass transition temperature; Thermomechanical method;
D O I
10.1007/s00590-017-1941-9
中图分类号
学科分类号
摘要
Background: In joint revision surgery, bone cement extraction remains a major challenge which even today has not seen a satisfactory solution yet. We studied in an experimental setting the impact of heat sources on the mechanical properties and microstructure of bone cement and determined the glass transition temperature (TG) of bone cement. As a result, it would be possible to establish a thermomechanical method which makes use of the structural and material-specific property changes inherent in bone cement at elevated temperatures. Methods: Prepared samples of polymerized bone cement were thermoanalyzed with a Netzsch STA 409 C thermal analyzer. Samples weighing approx. 55 mg were heated to 390 °C at a rate of 5 K/min. Both simultaneous differential thermal analysis and thermogravimetry were employed. The thermomechanically induced changes in the microstructure of the material were analyzed with a computed tomography scanner specifically developed for materials testing (3D-μXCT). Results: The bone cement changed from a firm elastic state over entropy-plastic (air atmosphere 60–155 °C) to a plastic viscosity state (air atmosphere >155 °C). Between 290 and 390 °C, the molten mass disintegrated (decomposition temperature). Conclusion: Our study was able to determine the glass transition temperature (TG) of bone cement which was about 60 and 65 °C under air and nitrogen, respectively. Heating the dry bone cement up to at least 65 °C would be more than halve the strength needed to detach it. Bone cement extraction would then be easy and swift. © 2017, Springer-Verlag France.
引用
收藏
页码:1125 / 1130
页数:5
相关论文
共 27 条
[1]  
Bundesamt S., Fallpauschalenbezogene Krankenhausstatistik (DRG-Statistik). Diagnosen, Prozeduren, Fallpauschalen und Case Mix der vollstationären Patientinnen und Patienten in Krankenhäusern. Wiesbaden Fachserie 12 Reihe 6.4, 2012, Wiesbaden, (2011)
[2]  
Trampuz A., Widmer A.F., Infections associated with orthopedic implants, Curr Opin Infect Dis, 19, pp. 349-356, (2006)
[3]  
Learmonth I.D., Young C., Rorabeck C., The operation of the century: total hip replacement, Lancet, 370, 9597, pp. 1508-1519, (2007)
[4]  
Malchau H., Herberts P., Eisler T., Garellick G., Soderman P., The Swedish total hip replacement register, J Bone Joint Surg Am, 84-A, pp. 2-20, (2002)
[5]  
Busch C.A., Charles M.N., Haydon C.M., Fractures of distally-fixed femoral stems after revision arthroplasty, J Bone Joint Surg Br, 7, pp. 1333-1336, (2005)
[6]  
Egan K.J., Di Cesare P.E., Intraoperative complications of revision hip arthroplasty using a fully porous-coated straight cobalt-chrome femoral stem, J Arthroplast, 10, pp. S45-S51, (1995)
[7]  
Porsch M., Schmidt J., Raabe T., Possibilities of avoiding an Intra-femoral increase in pressure during hip revision surgery, Biomed Tech (Berl), 44, pp. 142-145, (1999)
[8]  
Gray F.B., Total hip revision arthroplasty: prosthesis and cement removal techniques, Orthrop Clin North Am, 23, pp. 313-319, (1992)
[9]  
Miller M.E., Davis M.L., MacClean C.R., Davis J.G., Smith B.L., Humphries J.R., Radiation exposure and associated risks to operating-room personnel during use of fluoroscopic guidance for selected orthopaedic surgical procedures, J Bone Joint Surg Am, 65, pp. 1-4, (1983)
[10]  
Akiyama H., Kawanabe K., Goto K., Ohnishi E., Nakamura T., Computer-assisted fluoroscopic navigation system for removal of distal femoral bone cement in revision total hip arthroplasty, J Arthroplasty, 22, pp. 445-448, (2007)