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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 1, 16-20.
doi: 10.1302/0301-620X.89B1.18369  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Reduction of the potential for thermal damage during hip resurfacing

H. S. Gill, DPhil, University Research Lecturer1; P. A. Campbell, PhD, Director2; D. W. Murray, FRCS(Orth), Consultant Orthopaedic Surgeon1; and K. A. De Smet, MD, Consultant Orthopaedic Surgeon3

1 Department of Orthopaedic Surgery, The Botnar Research Centre, University of Oxford, Nuffield, Orthopaedic Centre, Windmill Road, Headington, Oxford OX3, 7LD, UK.
2 Implant Retrieval Laboratory, J. Vernon Luck Research Centre, Orthopaedic Hospital, University College Los Angeles, 2400 South Flower Street, Los Angeles, California, 90007, USA.
3 Anca Medical Centre, Krijgslaan 181, 9000 Gent, Belgium.

Correspondence should be sent to Dr H. S. Gill; e-mail: richie.gill{at}ndos.ox.ac.uk

Resurfacing arthroplasty of the hip is being used increasingly as an alternative to total hip replacement, especially for young active patients. There is concern about necrosis of the femoral head after resurfacing which can result in fracture and loosening. Most systems use a cemented femoral component, with the potential for thermal necrosis of the cancellous bone of the reamed femoral head. We used thermal probes to record temperatures close to the cement-bone interface during resurfacing arthroplasty.

The maximum temperature recorded at the cement-bone interface in four cases was approximately 68°C which was higher than that reported to kill osteocytes. A modified surgical technique using insertion of a suction cannula into the lesser trochanter, generous pulsed lavage and early reduction of the joint significantly reduced the maximum recorded cancellous bone temperature to approximately 36°C in five cases (p = 0.014).

We recommend the modified technique since it significantly reduces temperatures at the cement-bone interface.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General