Effects of bone cement filling in rabbit proximal femoral medullary cavity on distal femoral blood flow and metabolism

Abstract

ObjectiveA rabbit model was used to evaluate the effects of bone-cemented hip arthroplasty on distal femoral blood flow and metabolism relative to that of the non-cemented contralateral leg.MethodsThe marrow cavity of the right hind femur was filled with bone cement. At each of the following time points, rabbits were randomly selected to receive an injection of one dose of 99mTc-methylene diphosphonate and then immediately scanned using a gamma camera: immediately postoperatively and at 4 and 8 weeks postoperatively. A BL-410 model biofunction experimental system was used to analyze the acquired images and determine the radioactive counts of each hind leg.ResultsThe X-ray and photographic images of the right femoral bones confirmed successful filling of the marrow cavity with bone cement. The radioactive counts were significantly lower in the experimental than control legs at each time point. The ratio of the radioactive count of the experimental to control leg increased considerably at each time point, but each ratio was <1.ConclusionBlocking the proximal femoral medullary cavity with bone cement was associated with significant lowering of the blood circulation of the femur and marrow, decreasing the distal femoral blood flow and bone metabolic rate.

Changes in bone density, intraosseous pressure of distal femoral articular cartilage and subchondral bone after proximal femoral medullary cavity cement filling in rabbits

“…It is well known that the implantation of bone cement into the medullary cavity leads to high IOP, which increases hypoxia at the distal end of the femur (31). This, in turn, could seriously affect bone and cartilage metabolism in the distal femur and result in a large loss of local bone mass (10).…”

“…In previous clinical observations, it was noted that some patients had pain and discomfort of the knee joint after artificial bone cement hip replacement (11), though the specific mechanisms underlying this were unclear. Our previous study found that blocking of PFMC with bone cement was associated with a significant decrease in blood circulation and bone metabolic rate of the distal femur (10). However, to the best of our knowledge, the effects of bone cement on bone mineral density (BMD), intraosseous pressure (IOP), articular cartilage and subchondral bone of the distal femur have not been explicitly reported.…”

“…There are negative effects of bone cement on tissue around the cement at both the proximal and the distal end of the femur (10). In previous clinical observations, it was noted that some patients had pain and discomfort of the knee joint after artificial bone cement hip replacement (11), though the specific mechanisms underlying this were unclear.…”