Revision arthroplasty facilitated by ultrasonic tool cement removal. Part I: In vitro evaluation

Ultrasonically driven tools (UDTs) have been developed to facilitate removal of bone cement and securely fixed cemented components during revision arthroplasty. A two-part study was performed to evaluate the efficacy and safety to these tools. Heat generation at the endosteal surface during prosthesis and cement removal with a UDT was examined in an in vitro human femoral revision model. The histologic changes produced by the UDT at the endosteal surface were evaluated with an in vivo canine model. The heat generation studies demonstrated one-degree (C) temperature elevations at the endosteal surface during cement removal. We conclude that UDT use is safe and effective in the removal of cement and secure prostheses during revision total hip arthroplasty.