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Bone cement penetration of the acetabulum in total hip replacement. An experimental study.

Cones of cement passing through, or below, the acetabulum may be seen after total hip replacement and are due either to iatrogenic perforation of the wall or to substantial bony defects. An experimental study was undertaken to establish which structures might be affected by these cones. In 20 cadaveric specimens, the acetabula were divided into 4 quadrants and, after the cement was set, the structures within the pelvis were dissected. In the antero-inferior quadrant the cement impinged on either the obturator nerve or vein, or the external iliac vein. Anterosuperiorly, these structures and the external iliac artery were impinged. In the posterior quadrants, the obturator muscle and nerve, and vessels, were affected, and inferiorly the external obturator muscle was also involved. The size of the cones depended on the bony depth of the acetabulum. Compared with screws, the cement can cause late complications through heat necrosis and continuous friction. The posterosuperior quadrant is the safest area to make holes for anchoring the cup.

Acetabulum↗

[Preparation of a cytostatic-containing bone cement].

Local application of cytostatic during therapy of tumors in bones is desirable. In these cases the drugs had to be incorporated in bone glue. Liberation, stability and side-effects have been estimated using methotrexate and doxorubicin (Adriblastin) in vitro. The liberation were determined in combination with auxiliary substances and even solidity of the bone glue was maintained.

Antineoplastic Agents↗

[Release and diffusion of methylmethacrylic monomers after the implantation of self curing bone cements. Study on laboratory specimens and animal experiments (author's transl)].

In this study the degree and the time interval of the release of toxic methylmethacrylic monomers in neighboring bone tissue has been investigated after implantation of self couring acrylic cements. It has been shown that the majority of unpolymerized monomers is diminuated by a biologically uneffective later polymerization; thus only a minor part of methylmethacrylic monomers undergoes diffusion. The processes occur mainly during the first 24 hrs after implantation and are below the laboratory detection after 2 weeks. Cement additives such as X-ray contrast materials (BaSO4 or ZrO2) do not influence these reactions. Among the cements investigated herein (CMW-bone cement, Surgical simplex, Palacos) pronounced differences in the release of residual monomers during the first week have clearly been demonstrated.

Animals↗

In vitro effects of bone cements on the cell cycle of osteoblast-like cells.

The effects of orthopaedic cements on the proliferation and cell cycle of in vitro cultured MG63 osteoblast-like cells were examined. Five different cements were mixed and extracted at different time intervals (15 and 60 min, 6, 24 and 48 h). Cell proliferation inhibition (CPI) was evaluated after 72 h culture as the toxicity parameter. As for the toxicity degree, the extracts were considered to have 'high toxicity' (CPI > or = 50%), 'medium toxicity' (50% > CPI > 25%), 'low toxicity' (CPI < or = 25%) and 'no toxicity' (CPI = 0). Cell cycle phases of MG63 cells were evaluated at 24, 48 and 72 h by flow cytometry; the DNA content was assessed using the propidium iodide uptake and the percentage of cells in the S phase was determined using 5'-bromodeoxyuridine uptake. According to our results, the toxicity is inversely correlated with the time interval between polymerization and extract preparation, and is different according to the cement type. For some cements the effects are still observed 48 h after polymerization. The damaging effect is not linked to a specific phase of the cell cycle, nor does it hamper the restarting of cell proliferation at 72 h.

Bone Cements↗