The effect on cortical bone of reaming and filling of canine tibial diaphysis with inert bone wax.

In canine studies the effect of intramedullary reaming on tubular bone was investigated in 4 dogs. Intramedullary reaming was further compared with reaming and intramedullary filling with bone wax in 6 dogs. Bone blood perfusion was measured by a microsphere technique and bone remodelling activity by 99mTc-MDP uptake. From histological sections bone necrosis and remodelling activity were estimated. The biological response increased with the surgical trauma. If the medullary cavity was only reamed, endosteal apposition was the predominant reaction. Obturation of the medullary cavity resulted in more vigorous subperiosteal and cortical reaction. It is concluded that the remodelling processes differ significantly between reamed bone and bone where the medullary cavity is reamed and blocked. Thus when testing bone cement the studies should include a control operation with obturation of the medullary canal in a way simulating bone cement.