Gill H S, Campbell P A, Murray D W, De Smet K A
Department of Orthopaedic Surgery, The Botnar Research Centre, University of Oxford, Nuffield, Orthopaedic Centre, Headington, Oxford, UK.
J Bone Joint Surg Br. 2007 Jan;89(1):16-20. doi: 10.1302/0301-620X.89B1.18369.
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 degrees 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 degrees C in five cases (p = 0.014). We recommend the modified technique since it significantly reduces temperatures at the cement-bone interface.
髋关节表面置换术正越来越多地被用作全髋关节置换术的替代方法，特别是对于年轻活跃的患者。人们担心表面置换术后股骨头坏死，这可能导致骨折和松动。大多数系统使用骨水泥固定的股骨部件，有可能导致扩髓后股骨头松质骨发生热坏死。我们在表面置换术中使用热探头记录靠近骨水泥 - 骨界面的温度。4例患者在骨水泥 - 骨界面记录到的最高温度约为68摄氏度，高于据报道可杀死骨细胞的温度。一种改良的手术技术，即在小转子处插入吸引套管、大量脉冲冲洗以及早期复位关节，在5例患者中显著降低了记录到的松质骨最高温度至约36摄氏度（p = 0.014）。我们推荐这种改良技术，因为它能显著降低骨水泥 - 骨界面的温度。
