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At least 595 records · Page 33Linked to original sources
PubMed1999

Apparent fracture toughness of acrylic bone cement: effect of test specimen configuration and sterilization method.

The plane strain fracture toughness of Palacos R bone cement was determined using linear elastic fracture mechanics (LEFM) principles and three different test specimen configurations: single edge notched three-point (SENB), rectangular compact tension (RCT), and chevron notched short rod (CNSR). Another aspect of the study was an investigation of the effect of three methods used to sterilize the powder constituents of the cement-none, gamma irradiation and ethylene oxide--on the fracture toughness of the fully polymerized material. A detailed justification is provided for using LEFM. The fracture toughness results obtained using the CNSR specimens were, on average, 14 and 16% higher than those obtained using the SENB and RCT types, respectively. These differences are accounted for in terms of differences in four aspects of these specimen configuration (namely, residual stress effects, loading rate, material inhomogeneity, and the nature of the test). For a given specimen configuration, gamma irradiation produced a statistically significant decrease in fracture toughness which, it is suggested, is due to the concomitant depreciation in molecular weight. For a given cement type, there is no statistically significant difference in fracture toughness results obtained using SENB and RCT specimens. It is thus suggested that either of these configurations can be used to determine the fracture toughness of acrylic bone cement.

Bone Cements↗
PubMed1986

Fixation of experimental osteotomies of the distal femur in rabbits with bone cement and cyanoacrylate.

A distal femoral osteotomy was fixed with liquid cyanoacrylate and bone cement in 25 rabbits. Follow-up was done at 1, 3, 6, 12, and 24 weeks. The distal portion of each femur was removed, fixed in alcohol, embedded in methylmethacrylate, sawed to 80 micron thickness for OTC-fluorescence study and microradiography, and cut to 5-micron sections for histological analysis. Radiological and careful microscopic (OTC labeling, microradiographic, and histological) studies showed healing of the osteotomies during the first 6 weeks after operation. However, at 12 and 24 weeks' follow-up only four of ten osteotomies had healed. According to these observations it is obvious that fixation of an osteotomy of the cancellous bone with bone cement and cyanoacrylate does not provide sufficient stability for successful healing.

Adhesiveness↗
PubMed1992

[Exposure of surgical/orthopedic operating room personnel to monomer vapors during the use of bone cements--review of the literature and report of experiences].

PMMA bone cements are used for the fixation of artificial joint replacements. During their application in the operating theater, a small amount of the monomer evaporates. Operating room staff and surgeons are often not adequately informed about the negative properties and the effects on health of these vapours. Basic information about monomers and their toxicity, and safety regulations have been compiled. On the basis of present knowledge, the authors do not regard the repeated use of bone cement throughout the course of a day to represent a hazard to health.

Air Pollutants, Occupational↗
PubMed2001

Principles of bone cement mixing.

This is the first in a series of four consecutive articles on bone cement mixing. It aims to bring to the perioperative practitioners' attention, all of the factors that will influence the quality and reproducibility of the bone cement they produce. The series will demonstrate how perioperative practitioners can have a direct influence on the successful long-term result of a hip or knee replacement.

Bone Cements↗
PubMed1997

Does the anchorage form and depth influence the pull-out strength of screws from bone cement? An experimental study.

The pull-out strengths of cortical screws inserted into soft, unpolymerised Refobacin Palacos bone cement (procedure S) and into hardened polymerised cement into which a hole had been drilled and tapped (procedure P) were compared. Cortical screws 58 mm in length, outer diameter 4.5 mm and inner diameter 2.95 mm were used. Screws were inserted into cement cylinders at 5 mm incremental depths between 10 and 30 mm. At a screw depth of less than 25 mm, the screws pulled out, and at a depth of greater than 25 mm, the screws broke in both procedures. There was no statistically significant difference in pull-out strength leading to burst or break between the two procedures for screws inserted to comparable depths, but there was a statistically significant difference regarding the screwing depth regardless of the procedure of screw insertion chosen. The average material stability (sigma) of the cortical screws used was calculated to be 1191 N/mm2, and the elasticity limit was 5137 N. This study demonstrated that the material stability and not the depth of screw insertion was the limiting parameter in screw anchorage in bone cement while static testing. To avoid screw breakage due to fatigue during continuous alternate loading, the screws should not be loaded above this value.

Analysis of Variance↗
PubMed2006

Safeness of Simplex-tobramycin bone cement in patients with renal dysfunction undergoing total hip replacement.

PURPOSE: To compare the pharmacokinetic profile of tobramycin in blood, urine, and at the operative site following the use of Simplex-tobramycin bone cement in primary total hip replacement between patients with and without renal dysfunction. METHODS: Six patients with renal dysfunction underwent cemented primary total hip replacement for osteoarthritis. The elution characteristics of Simplex-tobramycin bone cement in the 6 patients with renal dysfunction were compared with 9 patients who had normal renal function. Blood, urine, and drainage fluid specimens were collected for 72 hours postoperatively. RESULTS: Very high concentrations of tobramycin were seen in the drainage fluid of the 2 groups. Mean serum tobramycin levels peaked at postoperative 3 hours, and declined rapidly to negligible levels at 72 hours in both groups. Mean urinary tobramycin concentrations peaked at postoperative 12 hours and declined rapidly until 48 hours in both groups. Urinary tobramycin was excreted significantly more slowly in renal dysfunction group in the first 12 hours, but not thereafter. Although serum creatinine levels of the renal dysfunction group were higher throughout the study period, the difference was not significant. Both groups achieved excellent local delivery of the antibiotic with minimal systemic concentrations. CONCLUSION: Simplex-tobramycin bone cement appears to be an effective and safe means to deliver antibiotic for patients with renal dysfunction who undergo total hip replacement.

Aged↗
PubMedDate not supplied

Repair of five distal radius fractures with an investigational cancellous bone cement: a preliminary report.

OBJECTIVE: The purpose of the study was to evaluate the feasibility of Norian SRS bone cement injected percutaneously into a distal radius following reduction in both preventing loss of reduction as well as safety. DESIGN: The study was a prospective clinical study with an established protocol. SETTING: The study was conducted at the Massachusetts General Hospital following approval of the institutions Investigational Review Board. All patients were required to read and approve an informed consent document. PATIENTS: While twenty patients' radiographs fulfilled the requirement of a dorsally displaced extraarticular fracture to have occurred within 72 hours of presentation, only five consented to participate fully and one voluntarily withdrew after a six-month follow-up. INTERVENTION: All fractures were reduced under regional or general anesthesia, and the Norian SRS was introduced via a catheter system into the metaphyseal defect of the fracture. A short arm cast was applied and remained in place for six weeks. MAIN OUTCOME MEASUREMENTS: Radiographic parameters of fracture reduction were measured prospectively by an independent radiologist throughout the 12 months of the study. Clinical parameters of hand and wrist function were measured prospectively by an independent occupational therapist. RESULTS: At 12-month follow-up, radial length was a mean 9.9 mm with an average loss of < 1 mm; radial angle maintained at a mean 25.4 degrees; volar angle was within normal range (0-21 degrees) in 4; and 1 patient had a dorsal angle of 7 degrees. Wrist motion improved 50 percent between 6 weeks and 3 months and improved further by 12 months when grip strength reached a mean of 88 percent of the contralateral side. Dorsal and volar extrusion of injected Norian SRS in 4 patients resorbed over time. There were no clinically significant adverse effects or complications. CONCLUSIONS: Norian SRS proved to be clinically safe and effective as a cancellous bone cement to maintain fracture reduction of unstable extraarticular distal radius fractures.

Bone Cements↗
PubMed1998

[The influence of antibiotic content in CMWI bone cement on its bacteriostatic and mechanical properties].

The influence of antibiotic content in CMW1 bone cement on its bacteriostatic and mechanical properties has been investigated. It was found that antibiotics (beta lactams, II and III generation cefalosporins) preserved their bacteriostatic properties within bone cement. No significant impact of antibiotic content within CMW1 on its mechanical properties has been demonstrated.

Anti-Bacterial Agents↗
PubMed2003

Modelling heat transfer in a bone-cement-prosthesis system.

The heat transfer in a general bone-cement-prosthesis system was modelled. A quantitative understanding of the heat transfer and the polymerization kinetics in the system is necessary because injury of the bone tissue and the mechanical properties of the cement have been suggested to be effected by the thermal and chemical history of the system. The mathematical model of the heat transfer was based on first principles from polymerization kinetics and heat transfer, rather than certain in vitro observed properties, which has been the common approach. Our model was valid for general three-dimensional geometries and an arbitrary bone cement consisting of an initiator and monomer. The model was simulated for a cross-section of a hip with a potential femoral stem prosthesis and for a cement similar to Palacos R. The simulations were conducted by using the finite element method. These simulations showed that this general model described an auto accelerating heat production and a residual monomer concentration, which are two phenomena suggested to cause bone tissue damage and effect the mechanical properties of the cement.

Arthroplasty, Replacement, Hip↗
PubMed2000

Primary stabilizing effect of interbody fusion devices for the cervical spine: an in vitro comparison between three different cage types and bone cement.

Interbody fusion cages are small hollow implants that are inserted into the intervertebral space to restore physiological disc height and to allow bony fusion. They sometimes cause clinical complications due to instability, subsidence or dislocation. These are basic biomechanical parameters, which influence strongly the quality of a fusion device; however, only few data about these parameters are available. Therefore, the purpose of the present study was to investigate the primary stabilizing effect of four different cervical fusion devices in in vitro flexibility tests. Twenty-four human cervical spine segments were used in this study. After anterior discectomy, fusion was performed either with a WING cage (Medinorm AG, Germany), a BAK/C cage (Sulzer SpineTech, USA), an AcroMed cervical I/F cage (DePuy AcroMed International, UK) or bone cement (Sulzer, Switzerland). All specimens were tested in a spine tester in the intact condition and after implantation of one of the four devices. Alternating sequences of pure lateral bending, flexion-extension and axial rotation moments (+/- 2.5 Nm) were applied continuously and the motions in each segment were measured simultaneously. In general, all tested implants had a stabilizing effect. This was most obvious in lateral bending, where the range of motion was between 0.29 (AcroMed cage) and 0.62 (BAK/C cage) with respect to the intact specimen (= 1.00). In lateral bending, flexion and axial rotation, the AcroMed cervical I/F cages had the highest stabilizing effect, followed by bone cement, WING cages and BAK/C cages. In extension, specimens fused with bone cement were most stable. With respect to the primary stabilizing effect, cages, especially the AcroMed I/F cage but also the WING cage and to a minor extent the BAK/C cage, seem to be a good alternative to bone cement in cervical interbody fusion. Other characteristics, such as the effect of implant design on subsidence tendency and the promotion of bone ingrowth, have to be determined in further studies.

Biomechanical Phenomena↗
PubMed1985

Corneal ulcer after exposure to vapours from bone cement (methyl methacrylate and hydroquinone).

An operation nurse repeatedly developed a corneal ulcer while mixing bone cement. It is suggested that the ulcer developed because of a composite effect of vapours from bone cement (methyl methacrylate monomer and hydroquinone), in spite of the fact that the Occupational Health Guidelines and the national threshold limit values for chemical substances had been respected. In-vitro and in-vivo animal studies are reviewed.

Adult↗
PubMed2003

The pharmacokinetics of Simplex-tobramycin bone cement.

We prospectively investigated a consecutive series of ten patients undergoing a cemented primary total hip replacement (THR) for osteoarthritis in order to establish the elution characteristics of Simplex-tobramycin bone cement (Howmedica, Limerick, Ireland). Specimens of blood, urine and drainage fluid were collected for 72 hours postoperatively. Very high concentrations of tobramycin were found in the drainage fluid, with mean levels at one hour of 103 mg/l, which steadily declined to 15.1 mg/l after 48 hours. The mean serum tobramycin levels reached a peak of 0.94 mg/l at three hours and declined rapidly to 0.2 mg/l by 48 hours. The mean urinary tobramycin levels peaked at 57.8 mg/l at 12 hours with a rapid decline to 12.6 mg/l by 24 hours. There was a direct correlation between the amount of tobramycin bone cement which was implanted and the amount of tobramycin systemically absorbed. Excellent local delivery was achieved with minimal systemic concentrations. Simplex-tobramycin bone cement is an efficient and safe method for the delivery of antibiotics after THR.

Aged↗
PubMed2003

Bone cements and fillers: a review.

Charnley [1] developed the first bone cement in the 1960s using poly(methyl methacrylate) (PMMA), which remains the most widely used material for fixation of orthopaedic joint replacements. In the field of dentistry, zinc polycarboxylate and glass polyalkenoate cements received major research interest from the 1970s to the present day. The discovery of a well-integrated intermediate layer between bone and many bioactive ceramic phases from the calcium-phosphate system, such as hydroxyapatite (HA), resulted in the development of new cements incorporating such phases. These investigations ranged from the development of castable bioactive materials to modified bioactive composites. This paper attempts to give a broad overview of the many different types of cements that have being developed in the past and those which are being researched at the present time. It has lead to a set of fundamental design criteria that should be considered prior to the development of a cement for use as a bone cement or in applications requiring a bone substitute.

Journal Article↗
PubMed1997

Oestradiol release from self-setting apatitic bone cement responsive to plasma-calcium level in ovariectomized rats, and its physicochemical mechanism.

The effect of plasma calcium levels on the release of oestradiol from a self-setting apatite bone cement containing 0.5% oestradiol was investigated in ovariectomized rats. The profiles of in-vitro release from the cements in simulated body fluid containing 0, 5 or 10 mg calcium per 100 mL indicated that the rate of release of oestradiol decreased with increasing calcium concentration in the dissolution media. After subcutaneous implantation of oestradiol-loaded cement in healthy and vitamin D-deficient rats, oestradiol release in diseased rats with low plasma calcium levels was significantly higher than that in healthy rats. These results suggest that in-vitro release of oestradiol from apatite bone cement was dependent on the calcium concentration in the buffer and that the in-vivo release of oestradiol from apatite bone cement was dependent on plasma calcium levels.

Animals↗
PubMed1994

Methylmethacrylate bone cement does not release histamine in patients undergoing prosthetic replacement of the femoral head.

This study was designed to see if methylmethacrylate monomer bone cement released histamine in 13 patients undergoing total hip replacement surgery with a cemented prosthesis, compared with seven control patients receiving a cementless porous-coated prosthesis. Blood samples for plasma concentrations of histamine were obtained before the start of anaesthesia, immediately before insertion of methylmethacrylate bone cement into the shaft of the femur in the cemented fixation group or before insertion of the femoral component of the prosthesis in the cementless fixation group, and 15, 30 and 60 min after the start of implantation of the prosthesis. In both groups, changes in plasma histamine did not differ significantly from baseline before implantation of cement. There were no significant differences between groups. We conclude that methylmethacrylate bone cement does not release histamine during total hip replacement surgery.

Aged↗
PubMed1999

Water absorption characteristics and cytotoxic and biological evaluation of bone cements formulated with a novel activator.

A novel activator, N,N,Dimethylamino 4-benzyl laurate (DML) was used in the curing of acrylic bone cements, based on poly(methylmethacrylate). The water absorption characteristics were studied, and the behavior was found to be similar to commercial bone cements. The net amount of solubles were also in the same range as obtained for commercial cements cured with conventional activators. Biocompatibility tests were conducted on the neat activator (DML) and cured cements. The present study indicated that there were no toxic effects; furthermore, osteoblast-like cells were seen to proliferate and differentiate more readily on DML containing cements. The analysis of the effect of leachables from cements into the media showed continued cell proliferation and cell viability.

Bone Cements↗