Excessive heat generation during cutting of cement in the Robodoc hip-revision procedure

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Abstract
The ROBODOC system is a promising new method for removing cement with high-speed milling. Heat is generated during the milling process. This study was designed to measure temperatures in the cutting area, and to assess the risk of heat injury and the effectiveness of irrigation. We measured temperatures at the bone-cement cutting area in three experimental settings, two involving the proximal area comprising a cement mantle, and one the distal cement plug beneath the prosthesis. Without cooling facilities, a mean temperature of 94 °C was measured in proximal areas. However, this could effectively be reduced below 70 °C with irrigation. In the area of the distal cement plug, we measured a mean temperature of 172 °C without irrigation. In this area, the integrated irrigation system with an additional high-flow irrigation system could not guarantee cooling to an acceptable temperature of below 70 °C since the irrigation stream was impeded by the cutter in the narrow cavity. We need an integrated irrigation device that guarantees continuous cooling at the cutting interface in front of the cutter.

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