A model was developed to simulate bleeding from cancellous bone at the physiologic pressures and flow rates that can occur during total hip arthroplasty. The consequences of simulated bleeding on the penetration of bone cement into cancellous bone, the shear strength of the cement-bone interface, and the shear strength of bone cement were investigated. In the presence of active bleeding, the shear strength of the cement-bone interface was reduced significantly in 50% of interfaces in which cements of lower viscosity were used. The simulated bleeding did not exert a detrimental effect on the depth of cement penetration.
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