Correlation of bone cement polymerization and cooling with thermal damage of cancellous bone and skeletal muscle
Objective To analyze the correlation of bone cement polymerization and cooling with thermal damage of cancellous bone and skeletal muscle.Methods 60 patients with knee osteoarthritis were selected as the study subjects,and their isolated tibial plateau block or femoral and ankle osteotomy were collected,and 4 samples were collected from each patient.According to the different methods of bone cement treatment,the patients were divided into group A(injecting bone cement into the interface of cancellous bone and surrounding skeletal muscle tissues of the isolated specimen alone),group B(injecting bone cement into the interface of cancellous bone and surrounding skeletal muscle tissues of the isolated specimen while cooling with normal saline at room temperature),group C(injecting bone cement into the interface of cancellous bone and surrounding skeletal muscle tissues of the isolated specimen while cooling with 4℃normal saline),with 20 cases in each group(80 samples).Paraffin sectioning and hematoxylin eosin staining were performed on labeled samples after surgery.The three groups were compared in terms of maximum local temperature,time of mixing to the maximum temperature,and duration of temperature above 40℃.The changes at the interface between the bone cement and cancellous bone and the surrounding skeletal muscle tissues under the naked eye and the cellular morphological changes at the interface between the bone cement and cancellous bone and the surrounding skeletal muscle tissues under the microscope were analyzed.Results The maximum local temperature and duration of temperature above 40℃of group A were(61.58±2.75)℃and(227.83±22.21)s,the maximum local temperature of group B and group C were(50.08±2.05)and(44.73±1.45)℃,which were lower than that of group A;the duration of temperature above 40℃of group B and group C were(127.64±12.83)and(53.33±10.79)s,which were shorter than that of group A(P<0.05);compared with group C,the maximum local temperature of group B was higher,and the duration of temperature above 40℃was longer(P<0.05).There was little difference between the three groups in the time of mixing to maximum temperature(P>0.05).Gross observation revealed that the cancellous bone and surrounding skeletal muscle tissue was less altered in group B and group C compared with group A,and group C was the least altered;microscopic observation revealed that compared with group A,group B and group C had less microscopic inflammatory cell infiltration,and group C had the least microscopic inflammatory cell infiltration.Conclusion For patients with knee arthritis undergoing knee replacement,the cooling treatment with the injection of bone cement is helpful to reduce the maximum local temperature and shorten the duration of temperature above 40℃.Compared with the cooling treatment with normal saline at room temperature,the effect of cooling treatment with 4℃normal saline is better,which can more effectively reduce the thermal damage and local inflammatory reaction of cancellous bone and skeletal muscle,and the repair time after thermal damage of the body tissue is shorter,which can be further applied in clinical practice.
Bone cementCancellous boneSkeletal muscleThermal damage
万方数据
维普
