Aksu Neslihan, Hiz V M Murat, Bilgili M Gökhan, Aksu Taner, Düzgün Oktay
Department of Orthopedics and Traumatology, European Florence Nightingale Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2003;37(5):386-94.
We administered saline solution at 70 degrees C and methylmethacrylate to varying volumes of bone cavities and compared temperature changes produced in bone regions at varying distances to the cavity wall.
We created varying sizes of cavities in the femoral heads of 20 human cadavers (6, 10, 12, and 20 cubic centimeters) and in the knee region of a human cadaver (6, 10, 12, 20, 30, and 40 cubic centimeters). Initially, saline solution at 70 degrees C was administered to all the cavities for 15 minutes by a pulse-irrigation method, during which temperature changes induced within the bone cavity and at specific distances (1, 2, 3, and 10 mm) to the cavity wall were recorded. The bone temperatures were allowed to return to initial values; thereafter, cement was applied and temperature changes at the same distances to the cavity wall, in the cement center, and on the cement surface were recorded.
Cement volumes up to 40 cubic centimeters applied to the bone cavities did not produce temperature increments that are reported to be adequate to induce necrosis in the cavity wall. It was thought that cement-induced necrosis in the bone-cement interface was not related to heat, but to other effects exerted by cement application. Compared to cement-induced temperature changes, saline solution at 70 degrees C was always associated with higher temperature increments in the cavity wall.
Due to its simple applicability at desired temperatures and for any lengths of time, heated saline solution seems to have credentials to be incorporated into local adjuvants that are utilized to eliminate tumoral contamination in the cavity wall following curettage for local aggressive tumors.