BoneCement课件

1、pmma( (-1970s)(1970s-1990s)(1990s- ) includes second generation techniques porosity reduction in the cement pressurization of the cement mantle after insertion centralization of the femoral stem within the cement mantle npma: a powder containing copolymers based on the substance methacrylatenmma : a

2、 liquid monomer methylmethacrylate application areasnhiptotal hip replacement (thr)hybrid hip / bipolar hiprevision hipnkneetotal knee replacement (tkr)uni kneerevision kneenspinevertebroplastymodern cementing techniquesnclean bone bednhigh and reprosucible bone cement qualityngood cement fillingnsa

3、fe working environmentbone bed preparationn reamingn anchorage holesn cement restrictorn brushingn high-pressure pulse lavagethe bone cavity should be shaped to provide an even cement layer between the bone and prosthesis. anchorage holes will incresase the contact area between bone and cement, prov

4、iding for better fixation. the anchorage holes may be drilled and/or impacted.*1 *2in order to achieve good filling and pressurization in hip and knee arthroplasties, a small piece of bone or a cement restrictor may be used to plug the shaft. *3 to remove soft tissue and loose cancellous bone acetab

5、ular and femoral brushes *4 to remove remaining bone particles and debris *5 mixing and deliverynporosity in bone cementnhistory mixing and delivery systemsnvacuum mixing and collection under vacuumnclosed mixing systemnreproducible, homogenous mixncement deliveryngold standardnvacuum mixing in the

6、optivacnvacuum mixing in the palamixndecreased mechanical strength and fatigue life of bone cementnthe sources of porosity are found in the mixing and delivery stages: wetting of the powder mixing transfer from mixing container to application devicehand mixingvacuum mixing1. mixed by hand2. mixed in

7、 a common vacuum mixing system on the market3. mixed in the optivac vacuum mixing system123 *6 *7 *8a modern vacuum mixing systems should meet the following requirements:monomer fume exposure at barely detectable levelsvacuum levels below 0.15 bar macroporosity below 0.5 area %microporosity below 1

8、pore per 100 mm2nmixing and collection under vacuumnreduced cement porositynincreased cement durabilityna standardized mixing procedurena homogenous cement mixturenreproducible high-quality cementnability to mix high and low viscosity cementsna closed systemn- elimination of direct contact with the

9、cement n- improved working environmentpressurization pressurization even cement layersweating trochanter sign*9*10*11*12safe working environmentnmonomer fume levels nskin contact nclosed mixing and delivery systemnprotective gloves revisionnantibiotic loaded revision cementnantibiotic loaded bone graftncement spacer moldsnseptopal beadstotal hip replacementreaminganchorage holesbrushingpulse lavageglovesbone cementcement mixing cement deliveryintroduction and alignment of the cup even cement mantleprotect the