title: Effects of pre-cooling and pre-heating procedures on cement polymerization and thermal osteonecrosis in cemented hip replacements.
abstract: Numerical studies were performed to investigate bone cement polymerization, temperature history and thermal osteonecrosis in cemented hip replacements with finite element methods. In this paper, the effects of pre-cooling and pre-heating of the prosthesis and/or the cement prior to implantation were simulated. It was found that the cement polymerization initiated near the bone-cement interface and progressed toward the prosthesis when both the cement and prosthesis were initially at room temperature. When the prosthesis and/or cement were pre-cooled, a reduction of the peak temperature at the bone-cement interface resulted, and this may reduce thermal osteonecrosis. However, this also slowed the polymerization process, and may result in a weaker bone cement. If the prosthesis was significantly initially heated, bone cement polymerization reversed reaction direction, started from the cement-prosthesis interface and proceeded toward the bone. Such polymerization direction may reduce or eliminate the formation of voids at the cement-prosthesis interface. Numerical results also showed that pre-heating seemed unlikely to produce significant thermal damage to the bone. The method of pre-heating the prosthesis prior to implantation may decrease the likelihood of cement-prosthesis loosening and increase the life of total hip arthroplasty.
authors.affiliation: Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, IN 46556, USA.
authors.forename: Chaodi
authors.initials: C
authors.lastname: Li
authors.forename: Steven
authors.initials: S
authors.lastname: Schmid
authors.forename: James
authors.initials: J
authors.lastname: Mason
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001843:Bone Cements / Q000737:chemistry* / Q000528:radiation effects; D002484:Cementation / Q000379:methods*; D003080:Cold Temperature / Q000009:adverse effects*; D003198:Computer Simulation; D019544:Equipment Failure Analysis; D005269:Femur / Q000737:chemistry / Q000473:pathology / Q000528:radiation effects / Q000601:surgery; D005271:Femur Head Necrosis / Q000209:etiology* / Q000473:pathology; D020342:Finite Element Analysis; D006622:Hip Prosthesis; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008954:Models, Biological; D008956:Models, Chemical; D011475:Prosthesis Failure; D013696:Temperature
chemical_list: D001843:Bone Cements