Analysis of fume emission from ultrasonic removal of methyl methacrylate cement in revision hip surgery.

Fumes emitted from the ultrasonic instrument while removing polymethyl methacrylate cement were analyzed in three separate phases: phase 1, cement removal from bovine femur in the laboratory; phase 2, methyl methacrylate fumes collected at primary cemented total knee arthroplasty; and phase 3, fumes collected at revision hip surgery. These fumes were collected via personal sampling pumps worn by operating room personnel to determine personal levels of exposure. In phase 1 peak levels of methyl methacrylate and butyl methacrylate were obtained. Phase 2 revealed the highest levels of methyl methacrylate to be only 1 part per million or less (well below the National Institute for Occupational Safety and Health recommended exposure limit of 100 parts per million), and in phase 3 there were no detectable levels of toxic substances. Therefore, we feel that the fumes emitted from the use of ultrasound in revision total hip arthroplasty are safe.