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Abstract
We measured femoral intramedullary pressures and applied axial thrust force generated
in vitro during reaming with the AO and Zimmer systems. Six pairs of cadaver femora
were instrumented with pressure taps midshaft and in the distal diaphysis, a load
cell distally to measure force, and a displacement transducer to monitor reamer position.
Following initial hand reaming, intramedullary power reaming was conducted utilizing
a 9-mm reamer initially, with subsequent increases in steps of 0.5 mm. All femora
were maintained at 37°C and albumin was used to maintain a fluid-filled canal. The
highest pressures consistently occurred during initial power reaming, with peak pressures
ranging from 270 to 1500 mmHg amongst femora with the AO system. No significant differences
were found in the peak pressures generated for the two systems (P =0.10). The pressure
measurements at the two locations in the femur were consistently similar, indicating
that pressures are continuous throughout this aspect of the femur. The pressures were
not correlated with instantaneous applied axial thrust (R2 = 0.191), and this could be attributed chiefly to the additional friction force of
cutting. While pressure generation in the medullary canal upon reaming is likely governed
by the rate of clearance of canal content, this is a highly variable response produced
by characteristics of the femur which are still not fully understood.
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References
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Article info
Publication history
Accepted:
April 4,
1995
Identification
Copyright
© 1995 Published by Elsevier Inc.
