Conduction analysis of cement interface temperature in total knee arthroplasty

Area of Science:

• Biomedical Engineering
• Orthopedic Surgery
• Materials Science

Background:

• Bone cement used in total knee arthroplasty (TKA) generates heat, potentially causing thermal bone necrosis.
• Understanding heat conduction is crucial for optimizing surgical techniques and patient outcomes.

Purpose of the Study:

• To investigate heat conduction from bone cement in TKA using finite element analysis.
• To predict the thermal necrotic map of bone and propose preventive strategies.

Main Methods:

• An axisymmetric finite element model of the tibia was developed using ABACUS software.
• Simulations analyzed heat conduction with an initial bone temperature of 32°C and varying cement layer thicknesses.
• Thermal effects were evaluated at the bone-cement interface over time.

Main Results:

• Maximum temperatures reached 65°C in the cement and 56°C at the bone-cement interface within 200 seconds.
• Bone necrosis was observed approximately 2mm from the interface with a 3mm cement layer.
• Reducing cement layer thickness to <1mm or initial bone temperature to <28°C eliminated necrosis.
• Cooling the prosthesis with water did not reduce maximum temperatures or necrotic areas.

Conclusions:

• A thin cement layer (<1mm) and pre-cooling the bone are effective methods to prevent thermal bone necrosis.
• Finite element analysis provides a valuable tool for simulating and mitigating thermal risks in TKA.
• Optimizing cement application and bone preparation can improve TKA safety and efficacy.