AI Article Synopsis

  • The study compared the thermal effects of using different amounts of PMMA to augment titanium PFNA blades in human cadaveric femoral heads.
  • No temperatures above 45°C were recorded, with the maximum exposure time over 41°C being 8.5 minutes in the highest volume group (6 mL).
  • The findings indicate that while using up to 6 mL of PMMA does not pose a risk of thermal bone necrosis, it's advisable to limit cement use to avoid potential biological impact.

Article Abstract

Background: Previous studies have clearly demonstrated superior biomechanical behavior of augmented proximal femoral nail antirotation (PFNA) blades compared with nonaugmented ones with respect to implant cutout. Nevertheless, there is concern about thermal bone necrosis due to exothermic curing of polymethylmethacrylate (PMMA)-based bone cements. The objective of this study was to quantify the temperatures arising around perforated titanium PFNA blades when augmenting with PMMA.

Methods: Cylindrical samples from six pairs of fresh frozen human cadaveric femoral heads implanted with a PFNA blade were placed in a 37°C water bath and augmented with 3 mL and 6 mL PMMA. During augmentation, temperatures were measured using six K-type thermocouples that were placed at controlled distances around the implant. With the help of high-resolution quantitative computed tomography images, the locations of all thermocouples with respect to the cement-bone interface were reconstructed.

Results: No temperatures higher than 45°C were measured in the interface region and the surrounding cement-free cancellous bone. In the same regions, the longest exposure time above 41°C was 8.5 minutes and was measured in a 6-mL sample. Average maximum temperature was significantly lower for the 3-mL group compared with the 6-mL group (p = 0.017).

Conclusion: The results of this study suggest that augmentation of titanium PFNA blades is not associated with a risk of thermal bone necrosis when using up to 6 mL of PMMA. However, larger amounts of cement lead to higher temperatures. PMMA application should therefore be kept low to minimally alter the biological system.

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Source
http://dx.doi.org/10.1097/TA.0b013e318248bfa7DOI Listing

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