Temperature Evaluation During PMMA Screw Augmentation in Osteoporotic Bone-An In Vitro Study About the Risk of Thermal Necrosis in Human Femoral Heads
Temperature Evaluation During PMMA Screw Augmentation in Osteoporotic Bone-An In Vitro Study About the Risk of Thermal Necrosis in Human Femoral Heads
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DOI：
10.1002/jbm.b.31353
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发表时间：
2009-08-01
影响因子：
3.4
通讯作者：
Gisep, Armando
中科院分区：
文献类型：
--
作者：
Boner, Vanessa;Kuhn, Philipp;Gisep, Armando
使用聚甲基丙烯酸甲酯(PMMA)骨水泥来增加髋部螺钉可降低切断风险，但与放热反应有关。这项体外研究评估了增加PMMA植入物购买量时热坏死的风险。一项初步研究分析了不同PMMA层厚度对植入物周围温度的影响。主要研究使用3.0或6.0cc聚甲基丙烯酸甲酯对人股骨头进行髋关节螺钉增强。根据文献报道的临界值估计热坏死的风险。测量了PMMA内部的最高温度，从PMMA中心到PMMA/骨界面的平均最高温度显著下降。当PMMA层厚度大于5.0 mm时，存在热坏死风险。在主要研究中，我们发现在PMMA/骨界面或周围骨中没有热坏死的风险，无论是3.0毫升还是6.0毫升的PMMA。这两项研究的结果在与相关水泥层厚度相关的平均峰值温度方面是一致的。这项体外研究的结果减少了当使用高达6.0cc的PMMA增加髋部螺钉周围的松质骨时热坏死风险的异议。(C)2009年威利期刊公司生物材料资源B部分：APPL生物材料90B：842-848,2009
The use of polymethylmethacrylate (PMMA) bone cement to augment hip screws reduces cut-out risk but is associated with an exothermic reaction. This in vitro investigation evaluated the risk of thermal necrosis when augmenting the implant purchase with PMMA. A pilot study analyzed the effects of different PMMA layer thicknesses on temperatures around an implant. The main study used either 3.0 or 6.0 cc PMMA for hip screw augmentation in human femoral heads. The risk of thermal necrosis was estimated according to critical values reported in literature. Highest temperatures were measured inside the PMMA with a significant drop of average maximum temperatures from the center of the PMMA to the PMMA/bone interface. Risk of thermal necrosis exists with PMMA layer thicknesses greater than 5.0 mm. In the main study, we found no risk of thermal necrosis at the PMMA/bone interface or in the surrounding bone, neither with 3.0 nor 6.0 cc PMMA. The results of the two studies were consistent regarding average peak temperatures related to associated cement layer thicknesses. The results of this in vitro study reduce objections concerning the risk of thermal necrosis when augmenting cancellous bone around hip screws with up to 6.0 cc PMMA. (C) 2009 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 90B: 842-848, 2009