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J Bone Joint Surg Br ; 86(8): 1214-9, 2004 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-15568540

RESUMEN

Fatigue fractures which originate at stress-concentrating voids located at the implant-cement interface are a potential cause of septic loosening of cemented femoral components. Heating of the component to 44 degrees C is known to reduce the porosity of the cement-prosthesis interface. The temperature of the cement-bone interface was recorded intra-operatively as 32.3 degrees C. 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 3 degrees C was required to produce this effect. The optimal difference was 7 degrees C, representing a balance between maximal reduction of porosity and an increased risk of thermal injury. Using contemporary cementing techniques, heating the implant to 40 degrees C is recommended to produce an optimum effect.


Asunto(s)
Artroplastia de Reemplazo de Cadera/métodos , Cementos para Huesos , Cabeza Femoral/fisiología , Prótesis de Cadera , Calor , Cementación , Cabeza Femoral/cirugía , Humanos , Fotomicrografía , Porosidad , Falla de Prótesis
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