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PubMed1975

Bone cement.

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Bone Cements↗
PubMed2000

Correlation between impact strength and fracture toughness of PMMA-based bone cements.

The thrust of the work involved determining the impact strength, IS (in kJ m(-2)) [using non-ASTM-sized Charpy-type specimens and an in-house impact tester] and fracture toughness, K1c (in MPa square root(m)) [using ASTM-sized rectangular compact tension specimens] of Surgical Simplex P and three variants of Palacos R acrylic bone cements. The attractions and drawbacks of this method for determining IS are detailed. The best fit to the K1c and IS results yielded a power relationship K1c = 0.795(IS)(0.59). The usefulness and limitations of this relationship are detailed.

Biomechanical Phenomena↗
PubMed2006

Femoroplasty--augmentation of the proximal femur with a composite bone cement--feasibility, biomechanical properties and osteosynthesis potential.

BACKGROUND: Analogous to vertebroplasty, cement-augmentation of the proximal femur ("femoroplasty") could reinforce osteoporotic bones. This study was to evaluate (i) the feasibility of femoroplasty with a composite cement (Cortoss), (ii) its influence on femoral strength by mechanical testing and (iii) the feasibility of stable osteosynthesis of the augmented fractured bones. METHODS: Nine human cadaveric femora were augmented with a composite bone cement, the surface heat generation monitored, and then tested biomechanically against their native contralateral control to determine fracture strength. Subsequently, thirteen reinforced and fractured femora were osteosynthetized by different implants and tested against their osteosynthetisized, non-augmented contralateral control. FINDINGS: Cement could be injected easily, with a moderate temperature rise. A positive correlation between BMD and fracture load and a significant increase in fracture load (+43%) of the augmented femora compared to their native controls (6324 N and 4430 N, respectively) as well as a significant increase in energy-to-failure (+187%, 86 N m and 30 N m, respectively) was found. Osteosynthesis was possible in cement-augmented femora. Osteosynthetisized femora showed equivalent strength to the intact controls. INTERPRETATION: Augmentation of the proximal femur with composite bone cement could be of use in prophylaxis of fractures in osteoporotic femurs. Osteosynthesis of the fractured augmented bones is a challenging procedure but has a good chance to restore strength.

Biomechanical Phenomena↗
PubMed1990

Study of the mineral-organic linkage in an apatitic reinforced bone cement.

In order to increase mechanical properties of surgical cements, an apatitic filler has been linked to the polymethylmethacrylate (PMMA) matrix. We report here the study of the linkage between the mineral and organic components by a dielectric spectroscopy: Thermally Stimulated Current. First, the mineral-organic interface between apatitic-octocalcic phosphate and hydroxyethylmethacrylate (HEMA) has been investigated. Second, the filler-matrix interface between grafted apatite and PMMA has been examined. It has been shown that the filler is chemically linked to the matrix and stiffens the PMMA bone cement.

Apatites↗
PubMed2000

Biomechanical evaluation of a new bone cement for use in vertebroplasty.

STUDY DESIGN: Comparative ex vivobiomechanical study. OBJECTIVES: To determine the strength and stiffness of osteoporotic vertebral bodies subjected to compression fractures and subsequently stabilized via bipedicular injection of one of two bone cements: one is a commercially available polymethylmethacrylate (Simplex P) and one is a proprietary glass-ceramic-reinforced BisGMA/BisEMA/TEGDMA matrix composite that is being developed for use in vertebroplasty (Orthocomp). SUMMARY OF BACKGROUND DATA: Osteoporotic compression fractures present diagnostic and therapeutic challenges for the clinician. Vertebroplasty, a new technique for treating such fractures, stabilizes vertebral bodies by injection of cement. Little is known, however, about the biomechanics of this treatment. METHODS: Five vertebral bodies (L1-L5) from each of four fresh spines were harvested from female cadavers (age, 80 +/- 5 years), screened for bone density using DEXA (t = -3.4 to -6.4), disarticulated, and compressed in a materials testing machine to determine initial strength and stiffness. The fractures then were repaired using a transpedicular injection of either Orthocomp or Simplex P and recrushed. RESULTS: For both cement treatments, vertebral body strength after injection of cement was significantly greater than initial strength values. Vertebral bodies augmented with Orthocomp recovered their initial stiffness; however, vertebral bodies augmented with Simplex P were significantly less stiff than they were in their initial condition. CONCLUSIONS: Augmentation with Orthocomp results in similar or greater mechanical properties compared with Simplex P, but these biomechanical results have yet to be substantiated in clinical studies.

Aged↗
PubMed2003

Delayed hypoxemia after bone cement insertion during total hip replacement under spinal anesthesia--a case report.

We report a case of delayed hypoxemia in an aged healthy male patient, which developed 2 hours after cementation of the prosthesis in total hip replacement (THR) under spinal anesthesia. The patient was doing well throughout the operation but unfortunately, progressive tachypnea was noted 1 h after he was transferred to the recovery room (i.e. 2 h after the application of bone cement into the femur). An hour further, distinct wheeze was heard bilaterally on auscultation, which signified bronchospasm. Arterial blood gases analysis revealed a low PaO2 of 71 mmHg and a decrease of oxygen saturation to 91% with supplement of fractional oxygen of 35%. Aerosolization of bronchodilator with terbutaline was administered and supplemental fractional oxygen was increased to 50%. Although wheezing soon subsided, tachypnea and desaturation persisted. He was then transferred to the surgical intensive care unit for further management. Ventilation-perfusion lung scan was performed, which was suggestive of multiple pulmonary embolism.

Aged↗
PubMed1998

Application of long chain amine activator in conventional acrylic bone cement.

A long chain acid derivative bearing an aromatic tertiary amine group, 4-N,N-dimethylaminobenzyl laurate (DML), which acts as an activator for the curing of acrylic cements at low temperature, has been synthesized and characterized to reduce the biological adverse effects usually associated with the classical activator N,N-dimethyl-4-toluidine (DMT). The effectiveness of the activator was tested on commercial formulations (e.g., Palacos R) and on experimental bone cements based on poly (methyl methacrylate) by using different benzoyl peroxide/amine molar ratios. The exotherms of polymerization were followed at three different temperatures: 25, 30, and 37 degrees C. The DML activator was found to be more sensitive to temperature than the corresponding DMT. DML provided exotherms of polymerization with decreasing peak temperatures and increasing setting times without impairing the mechanical properties. Residual monomer content was analyzed in a range of activator concentrations by keeping the benzoyl peroxide concentration constant. In all cases the residual monomer content was lower than 5%, indicating its good efficiency in the benzoyl peroxide initiated polymerization.

Bone Cements↗
PubMed2004

[Sensitivity to constituents of bone cement in a patient with joint prosthesis].

Failure to tolerate prosthetic material can lead to a variety of clinical findings. A 55-year-old woman had a total replacement of the right knee. Two weeks later she developed pruritic skin lesions over the joint, as well as pain and impaired function. Allergic testing showed clinically relevant Type IV sensitization to methylmethacrylate, as well as to various formulations of the bone cement, including one with an added antibiotic. The symptom complex of pruritic skin lesions in the area of the prosthesis, pain and disability, as well as relevant Type IV sensitization justified replacing the prosthesis.

Bone Cements↗
PubMed2004

Wear behaviour of the pair Ti-6Al-4V-UHMWPE of acrylic bone cements containing different radiopaque agents.

The objective of this study was to improve the wear behaviour of acrylic bone cements by substituting the conventional inorganic radiopaque agents (BaSO(4), ZrO(2)) for different iodinated radiopaque monomers which can co-polymerize with the methyl methacrylate monomer, MMA. To this aim, the wear behaviour of the pair Ti-6Al-4V-UHMWPE (ultra high molecular weight polyethylene) was studied in the absence and in the presence of cement particles (the third body).

Alloys↗