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Intraosseous temperature during autoclaving

P Böhm1, J Stihler

  • 1University Hospital, Tübingen, Germany.

The Journal of Bone and Joint Surgery. British Volume
|July 1, 1995
PubMed
Summary

Autoclaving bone tumor resections for limb salvage surgery may not sufficiently kill all cancer cells. Temperatures in calf femora during autoclaving varied significantly, with the lateral condyle reaching only 45°C, potentially insufficient for complete tumor cell destruction.

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Area of Science:

  • Orthopedic Surgery
  • Oncology
  • Biomedical Engineering

Background:

  • Limb salvage surgery for bone tumors often involves wide resection and reimplantation of the excised bone segment.
  • Extracorporeal devitalization using autoclaving is a method to sterilize the bone segment before reimplantation.
  • Ensuring complete tumor cell kill is critical for successful oncological outcomes.

Purpose of the Study:

  • To investigate temperature distribution within calf femora during autoclaving at 134°C.
  • To identify areas within the bone segment that may not reach sterilizing temperatures.
  • To assess the efficacy of autoclaving in achieving complete tumor cell devitalization.

Main Methods:

  • Calf femora were subjected to autoclaving at 134°C in two different autoclaves.
  • Temperature monitoring was conducted at multiple sites within the medullary cavity, femoral head, medial condyle, and lateral condyle.
  • Autoclaving cycles varied in duration, with a short program of 11 minutes being specifically analyzed.

Main Results:

  • Significant temperature variations were observed across different anatomical locations within the femora.
  • The lateral condyle, composed primarily of cancellous bone, exhibited the lowest recorded temperatures.
  • A short autoclaving cycle (11 minutes) resulted in a minimum temperature of 45°C in the lateral condyle, potentially inadequate for tumor cell eradication.

Conclusions:

  • Standard autoclaving protocols may not guarantee complete devitalization of bone tumor segments, particularly in cancellous bone regions like the lateral condyle.
  • Further optimization of autoclaving parameters or alternative sterilization methods may be necessary to ensure oncological safety in limb salvage surgery.
  • The findings highlight the importance of temperature monitoring in validating sterilization techniques for bone tumor reimplantation procedures.

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