TITLE

Thermal Effects of Glenoid Reaming During Shoulder Arthroplasty in Vivo

AUTHOR(S)
Olson, Soren; Clinton, Jeremiah M.; Working, Zachary; Lynch, Joseph R.; Warme, Winston J.; Womack, Wesley; Matsen III, Frederick A.
PUB. DATE
January 2011
SOURCE
Journal of Bone & Joint Surgery, American Volume;1/5/2011, Vol. 93-A Issue 1, p11
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Glenoid component loosening is a common cause of failure of total shoulder arthroplasty. It has been proposed that the heat generated during glenoid preparation may reach temperatures capable of producing osteonecrosis at the bone-implant interface. We hypothesized that temperatures sufficient to induce thermal necrosis can be produced with routine drilling and reaming during glenoid preparation for shoulder arthroplasty in vivo. Furthermore, we hypothesized that irrigation of the glenoid during reaming can reduce this temperature increase. Methods: Real-time, high-definition, infrared thermal video imaging was used to determine the temperatures produced by drilling and reaming during glenoid preparation in ten consecutive patients undergoing total shoulder arthroplasty. The maximum temperature and the duration of temperatures greater than the established thresholds for thermal necrosis were documented. The first five arthroplasties were performed without irrigation and were compared with the second five arthroplasties, in which continuous bulb irrigation was used during drilling and reaming. A one-dimensional finite element model was developed to estimate the depth of penetration of critical temperatures into the bone of the glenoid on the basis of recorded surface temperatures. Results: Our first hypothesis was supported by the recording of maximum surface temperatures above the 56°C threshold during reaming in four of the five arthroplasties done without irrigation and during drilling in two of the five arthroplasties without irrigation. The estimated depth of penetration of the critical temperature (56°C) to produce instantaneous osteonecrosis was beyond 1 mm (range, 1.97 to 5.12 mm) in four of these patients during reaming and one of these patients during drilling, and two had estimated temperatures above 56°C at 3 mm. Our second hypothesis was supported by the observation that, in the group receiving irrigation, the temperature exceeded the critical threshold in only one specimen during reaming and in two during drilling. The estimated depth of penetration for the critical temperature (56°C) did not reach a depth of 1 mm in any of these patients (range, 0.07 to 0.19 mm). Conclusions: Temperatures sufficient to induce thermal necrosis of glenoid bone can be generated by glenoid preparation in shoulder arthroplasty in vivo. Frequent irrigation may be effective in preventing temperatures from reaching the threshold for bone necrosis during glenoid preparation. Level of Evidence: Therapeutic LevelII. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
57308549

 

Related Articles

  • Proper patient selection, surgical technique have proven essential for minimizing risks and ensuring quality outcomes. Blazek, Nicole // Orthopaedics Today Europe;Jul/Aug2011, Vol. 14 Issue 4, p6 

    The article focuses on the increasing popularity of reverse shoulder arthroplasty as an innovative shoulder procedure for restoring motion and relieving pain in patients with shoulder injuries.

  • Use of ultrasound by shoulder surgeons: is there an urgent need for new guidance on the required standard for competency? Bidwai, A. S. C.; Casserly, H. B. // Ultrasound;Aug2011, Vol. 19 Issue 3, p130 

    No abstract available.

  • AANA/SOMOS collaborate on course. Leahy, Maureen // AAOS Now;Nov2010, Vol. 4 Issue 11, p13 

    A description of the course "Advanced Shoulder Arthroscopy" being offered at the Orthopaedic Learning Center (OLC) in Rosemont, Illinois is provided.

  • One best indication: Cuff tear arthropathy. Porcelllni, Giuseppe // Orthopaedics Today Europe;Jul/Aug2011, Vol. 14 Issue 4, p7 

    The author discusses why cuff tear arthropathy is his main indication for reverse shoulder arthroplasty (RSA).

  • Geometrical analysis of stemless shoulder arthroplasty: a radiological study of seventy TESS total shoulder prostheses. Kadum, Bakir; Hassany, Hamid; Wadsten, Mats; Sayed-Noor, Arkan; Sjödén, Göran; Sjödén, Göran // International Orthopaedics;Apr2016, Vol. 40 Issue 4, p751 

    Purpose: The aim of this study was to investigate the ability of a stemless shoulder prosthesis to restore shoulder anatomy in relation to premorbid anatomy. Methods: This prospective study was performed between May 2007 and December 2013. The inclusion criteria were...

  • Ask the Experts: DVT prophylaxis following total shoulder for trauma injuries.  // Orthopedics Today;Feb2011, Vol. 31 Issue 2, p17 

    The article presents answers to a question on the use of deep vein thrombosis (DVT) prophylaxis following total shoulder arthroplasty with fractures at a panel discussion on different treatments for shoulder and upper extremity trauma presented by Evan L. Flatow at Orthopedics Today Hawaii 2011.

  • Report on DSNA Annual Conference 2012 - Embracing Change. Latham, Gail; Finch, Beth // Day Surgery Australia;Nov2012, Vol. 11 Issue 3, p20 

    Information on the annual New South Wales Day Surgery Nurses Association (DSNA) conference held on August 25, 2012 at the Masonic Centre in Sydney is presented. Keynote speaker Di Adamson discussed how to influence people to want change and why change is needed in day surgery nursing. Dr. Mark...

  • Digital photography for assessment of shoulder range of motion: A novel clinical and research tool. O'Neill, Barry J.; O'Briain, David; Hirpara, Kieran M.; Shaughnesy, Michelle; Yeatman, Elizabeth A.; Kaar, T. Kenneth // International Journal of Shoulder Surgery;Jan-Mar2013, Vol. 7 Issue 1, p23 

    Purpose: Maintenance of a pain-free functional range of motion is the aim of surgery for shoulder trauma. The aim of this study was to show that the range of motion can be accurately assessed using digital photographs. Materials and Methods: We reviewed 17 patients who had undergone surgery for...

  • Product Briefs.  // Medical Device Daily;7/28/2011, Vol. 15 Issue 140, p6 

    The article reports on the U.S. Food and Drug Administration (FDA) clearance received by ArthroCare for its Speed Suture System, a push-in anchor made of polyether-etherketone (PEEK) polyner for the repair of tears of the labrum in a shoulder.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics