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PubMed1998

Histological, chemical, and crystallographic analysis of four calcium phosphate cements in different rabbit osseous sites.

Four calcium phosphate cement formulations were implanted in the rabbit distal femoral metaphysis and middiaphysis. Chemical, crystallographic, and histological analyses were made at 2, 4, and 8 weeks after implantation. When implanted into the metaphysis, part of the brushite cement was converted into carbonated apatite by 2 weeks. Some of the brushite cement was removed by mononuclear macrophages prior to its conversion into apatite. Osteoclastlike cell mediated remodeling was predominant at 8 weeks after brushite had converted to apatite. The same histological results were seen for brushite plus calcite aggregate cement, except with calcite aggregates still present at 8 weeks. However, when implanted in the diaphysis, brushite and brushite plus calcite aggregate did not convert to another calcium phosphate phase by 4 weeks. Carbonated apatite cement implanted in the metaphysis did not transform to another calcium phosphate phase. There was no evidence of adverse foreign body reaction. Osteoclastlike cell mediated remodeling was predominant at 8 weeks. The apatite plus calcite aggregate cement implanted in the metaphysis that was not remodeled remained as poorly crystalline apatite. Calcite aggregates were still present at 8 weeks. There was no evidence of foreign body reaction. Osteoclastlike cell remodeling was predominant at 8 weeks. Response to brushite cements prior to conversion to apatite was macrophage dominated, and response to apatite cements was osteoclast dominated. Mineralogy, chemical composition, and osseous implantation site of these calcium phosphates significantly affected their in vivo host response.

Animals↗
PubMed1999

Acid-base complex reactions in resin-modified and conventional glass ionomer cements.

Resin-modified glass ionomer cements are a recent development in which the desirable properties of glass ionomer cements and resin-composites are combined. The presence of resin may, however, retard the acid-base reaction of the ionomer component. This has led to a debate regarding the classification of resin modified materials as true glass ionomer cements, and the actual duration of the acid-base reaction after initial setting via light polymerization has taken place. To investigate this issue, a novel method employing FT-IR spectrophotometry was used to monitor the acid-base complexation reaction in a resin-modified glass ionomer cement (Fuji II LC) and a conventional, chemically cured cement (Fuji II Cap). This method involved subtraction of the background "resin" spectrum from the Fuji II LC spectra and subsequent application of a baseline to obtain the plot of absorbance area ratio in the range of 1685 to 1510 cm(-1) (complexed carboxyls) to that in the range of 1750 to 1685 cm(-1) (free carboxyls). This study demonstrates evidence of a delayed acid-base reaction for the resin-modified cement, which levels off after 168 hours of cement mixing. In contrast, the complexation reaction of the conventional glass ionomer cement was essentially complete after 24 hours.

Glass↗
PubMed1999

Effect of silane treatment and different resin compositions on biological properties of bioactive bone cement containing apatite-wollastonite glass ceramic powder.

In methylmethacrylate (MMA)-based cements containing bioactive particles, polymethylmetacrylate (PMMA) is known to suppress the bioactivity of Bioglass(R) and apatite-wollastonite glass ceramic (AW-GC). Little is known about the effect of different silane treatment methods on the bioactivity of AW-GC. MMA-based cement plates containing dry silanated AW-GC particles and PMMA particles of different molecular weights (12,000-900,000) were immersed in simulated body fluid (SBF). Cements containing PMMA particles of high molecular weight formed an apatite layer on the surface after 24 h. Using PMMA particles with a molecular weight of 60,000 and AW-GC particles silanated with different methods (dry method vs. slurry method), cement plates were made and immersed in SBF. Only cement plates containing dry silanated AW-GC particles showed apatite formation in SBF after 3 days. In vivo implantation in rat tibias of MMA-based cement containing dry silanated AW-GC particles and PMMA particles (molecular weight 900,000) demonstrated an affinity index of 32.1 +/- 15.8% after 8 weeks of implantation compared to 89.4 +/- 10.7% achieved by bisphenol-A-glycidyl methacrylate based cement containing the same bioactive powder. By using a dry method of silane treatment and high molecular weight PMMA particles, the bioactivity of cement based on MMA monomer was achieved; but further effort is needed to improve the mechanical properties of the composite.

Animals↗
PubMed2001

Bioactive bone cement: effect of filler size on mechanical properties and osteoconductivity.

A bioactive bone cement (designated GBC), consisting of bioactive glass beads as an inorganic filler and poly(methyl methacrylate) (PMMA) as an organic matrix, has been developed. The purpose of the present study was to examine the effect of the size of the glass beads added as a filler to GBC on its mechanical properties and osteoconductivity. Serial changes in GBC with time were also examined. Four different sizes of beads (mean diameters 4, 5, 9, and 13 microm) consisting of MgO-CaO-SiO(2)-P(2)O(5)-CaF(2) glass were added to four GBC mixes in a proportion of 70 wt %. The bending strength of GBC increased as the mean size of the glass beads decreased. The four GBC mixes were packed into the intramedullary canals of rat tibiae to evaluate osteoconductivity, as determined by an affinity index. Rats were sacrificed at 4 and 8 weeks after surgery. The affinity index, which equaled the length of bone in direct contact with the cement surface expressed as a percentage of the total length of the cement surface, was calculated for each cement at each interval. Histologically, new bone had formed along the surface of all types of GBC within 4 weeks. At each time interval, there was a trend for the affinity index of GBC to increase as the mean glass bead size decreased. The affinity indices for all types of GBC increased significantly with time up to 8 weeks. The handling properties of GBC were comparable to those of conventional PMMA bone cement. We concluded that, considering both mechanical properties and osteoconductivity, GBC made with smaller sized glass beads as filler was the most suitable cement. GBC shows promise as an alternative bone cement with improved properties compared to conventional PMMA bone cement.

Animals↗
PubMed1992

The effect of the addition of methylene blue on the fatigue strength of Simplex P bone-cement.

To aid in cement removal during revision arthroplasty, it has been proposed to add methylene blue to bone cement to provide contrast between the cement and bone. However, it is essential that the fatigue strength of the cement not be reduced by the addition of the methylene blue. The effect of adding 1 mL of an aqueous 1% solution of methylene blue to one pack of Simplex P prepared in the standard fashion (uncentrifuged) was studied. We also measured the fatigue properties of centrifuged Simplex P with three different methylene blue preparations. We studied adding 1 mL of an aqueous 1% solution of methylene blue, 0.5 g of methylene blue powder, and 0.1 mL of a 10% solution of methylene blue per pack of Simplex P bone cement. Adding 1 mL of a 1% methylene blue solution to 40 g of Simplex P without centrifuging the cement after mixing produced a cement with a mean fatigue life comparable to the uncentrifuged Simplex P without the methylene blue. However, the fatigue data scatter was higher for the uncentrifuged methylene blue preparation. The optimum methylene blue impregnated cement preparation was produced by adding 1 mL of a 1% methylene blue solution to 40 g of Simplex P powder, mixing with chilled monomer, and centrifuging for 60 s. Sterile 1 mL vials of 1% methylene blue solution are available in the operating room.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Cements↗
PubMed2002

Theoretical prediction and experimental determination of the effect of mold characteristics on temperature and monomer conversion fraction profiles during polymerization of a PMMA-based bone cement.

The present work is concerned with applications of a kinetic model for free-radical polymerization of a polymethylmethacrylate-based bone cement. Autocatalytic behavior at the first part of the reaction as well as a diffusion control phenomenon near vitrification are described by the model. Comparison of theoretical computations with experimental measurements for the temperature evolution during batch casting demonstrated the capacity of the proposed model to represent the kinetic behavior of the polymerization reaction. Temperature evolution and monomer conversion were simulated for the cure of the cement in molds made of different materials. The maximum monomer conversion fraction was markedly influenced by the physical properties of the mold material. The unreacted monomer acts as a plasticizer that influences the mechanical behavior of the cement. Hence, the same cement formulation cured in molds of different materials may result in different mechanical response because of the differences in the amounts of residual monomer. Standardization of the mold type to prepare specimens for the mechanical characterization of bone cements is recommended. Theoretical prediction of temperature evolution during hip replacement indicated that for cement thickness lower than 6 mm the peak temperature at the bone-cement interface was below the limit stated for thermal injury (50 degrees C for more than 1 min). The use of thin cement layers is recommended to diminish the risk of thermal injury; however, it is accompanied by an increase in the amount of unreacted monomer present in the cured material.

Arthroplasty, Replacement, Hip↗
PubMed1982

Intramedullary fixation of artificial hip joints with bone cement-precoated implants. I. Interfacial strengths.

In order to minimize the problems associated with implant fixation using acrylic bone cement, a new technique has been investigated. Canine hip prostheses were precoated with self-curing acrylic bone cement and implanted in random source dogs using the same cement for fixation, a precoated prosthesis on one side and an uncoated (control) on the other. After 1, 3, and 6 months, both femora were excised and sectioned for mechanical assessment of the interfaces among bone, cement, and implant. It was found that the precoated implants had much higher interfacial shear strengths than the uncoated ones (average 14.2 and 6.8 MPa for implant-cement interface; 2.0 and 1.2 MPa for the cement-bone interface for all implant periods). The precoated "old" cement and the "new" cement's interfacial shear strength was the strongest with an average of 15.1 MPa for all implant periods. The present results indicate that the precoated hemiarthroplastic implants provide a firmer intramedullary fixation than the traditional, uncoated implants.

Animals↗
PubMed1982

Intramedullary fixation of artificial hip joints with bone cement-precoated implants. II. Density and histological study.

Bilateral coxofemoral hemiarthroplasties were performed in dogs using experimental and control implants, which were fixed with bone cement. The stem of the experimental implant was precoated with bone cement, about 2 mm thick. After 1, 3, and 6 months the femora with implant specimens were harvested and sectioned for mechanical and histological evaluation. Histological observations on the implant-bone interface and density measurements of the bone cement are reported. The density of the precoated bone cement was higher than the same cement used for implant fixation at the time of implantation (1.202 vs. 1.188 g/mL). The precoating also resulted in milder histological reactions, including thinner fibrous tissue capsule and smaller gap between bone and cement. The present results and the previously reported mechanical findings strongly support our hypothesis that a better and longer lasting prosthesis fixation can be achieved using cement-precoated prosthesis combined with the customary cement fixation technique.

Animals↗
PubMed1983

Mechanical strength of poly(methyl methacrylate) cement-human bone interfaces.

A device was constructed to test the interfacial strength of PMMA-based bone cement and human cancellous bone under pure tension. Two types of tissue were used in the investigation: (1) formalin-fixed vertebral bone as an in vitro model for weak cancellous bone, and (2) freshly removed metatarsal bone. Tissue--cement joints were allowed to solidify under two different pressures (0.11 and 0.47 MPa), and cement placement time on tissue surfaces was also controlled as a variable. The higher curing pressure only seemed to enhance the strength of interfaces formed with mechanically weak fixed bone but had no significant effect for joints formed with the stronger, freshly extracted tissue. Cement placement time did not have a discernible effect on interfacial strength regardless of the tissue used or the pressure applied during setting. An analysis of fracture morphology by optical microscopy revealed largely cement cohesive failure in some cases and bone or mixed fractures in others. Joints exhibiting mainly cement fracture had the highest interfacial tensile strengths (in the order of 7.5 MPa). Once measured values of tissue porosity were taken into account, the observed joint strength correlated well with cement tensile strength. Based on experimental findings, better stress-dissipating qualities and higher tensile strength are suggested as two important necessary improvements of bone cements based on poly(methyl methacrylate).

Biomechanical Phenomena↗
PubMed1989

Influence of antibiotic impregnation on the fatigue life of Simplex P and Palacos R acrylic bone cements, with and without centrifugation.

The fatigue properties of Simplex P and Palacos R bone cements were compared to their antibiotic impregnated counterparts AKZ* and Palacos R with gentamycin. The effect of porosity reduction by centrifugation of all four cement types was also assessed. Fifteen specimens of each cement type were prepared according to manufacturer's instructions and 15 additional specimens of each cement type were prepared by mixing the powder with chilled monomer (0 degrees C) and then centrifuging the cement immediately after mixing. Fifteen fully reversed tension-compression fatigue tests were performed at 15 MPa in stress control for each cement preparation in vitro while simulating the in vivo state (37 degrees C and 100% humidity). The number of cycles to failure were recorded. There was no significant difference in the fatigue life of Palacos R and Simplex P when both cements were prepared in the standard fashion. The addition of 1/2 g of gentamycin to Palacos R did not significantly alter its fatigue properties. The addition of 0.5 g of erythromycin and 0.24 g of colistin did not decrease the fatigue life of Simplex P. Centrifugation significantly improved the fatigue properties of Simplex P and AKZ. The fatigue lives of Palacos R and Palacos R with gentamycin were not improved by centrifugation. The fatigue life of centrifuged Simplex P was significantly greater than the fatigue life of Palacos R and of Palacos R with gentamycin, whether the Palacos R based cements were centrifuged or not.

Biocompatible Materials↗
PubMed1990

A fractographic analysis of in vivo poly(methyl methacrylate) bone cement failure mechanisms.

Cementing with poly(methyl methacrylate) (PMMA) is a common means of fixing total hip prostheses. Bone cement fails mechanically, and subsequent loosening frequently requires correction via revision surgery. An initial step in optimizing bone cement properties is to establish which properties are critical to the material's in vivo performance. The objectives were to discern the critical in vivo failure mechanisms of bone cement. Fracture surfaces of bone cement specimens that failed in vivo were compared with fatigue and rapid fracture surfaces created in vitro. In vivo fracture processes of bone cement were positively identified and explained by the elucidation of PMMA fracture micromechanisms. The ex vivo fracture surfaces are remarkably similar to in vitro fatigue fracture surfaces. The fractographic data document that the primary in vivo failure mechanism of bone cement is fatigue, and the fatigue cracks grow by developing a microcraze shower damage zone. Agglomerates of BaSO4 particles can be implicated in some bone cement failures, large flaws or voids in vivo can lead to a rapid, unstable fracture, pores in the PMMA mass have a clear influence on a propagating crack, and wear of the fracture surfaces occurs, and may produce PMMA debris, exacerbating bone destruction.

Aged↗
PubMed1995

Dynamic creep behavior of acrylic bone cement.

Recent studies concerning the fixation of cemented total hip arthroplasty (THA) have led to new hypotheses about the dynamic, long-term failure mechanisms leading to prosthetic loosening. As a result, the long-term mechanical behavior of acrylic bone cement has gained more interest since little is known about these properties. In this study, the dynamic, compressive creep deformation of acrylic bone cement was examined. An amount of creep was found, with creep strains exceeding the elastic strain during 14 x 10(6) loading cycles. There was a linear relationship between the logarithmic values of the number of loading cycles and the creep strain. The effect of stress level on the amount of creep was different from that in results of static experiments reported in the literature. Comparing the results with tensile creep experiments revealed that bone cement under a tensile load creeps much quicker than under a compressive one. Young's modulus was significantly higher when the material was loaded at higher strain rates. The bone cement became stiffer with an increasing number of loading cycles. The creep behavior of bone cement is important for the long-term behavior of cemented THA. It enables subsidence of the stem and attenuation of stress peaks in the cement mantle.

Acrylates↗
PubMed2003

In vivo bone response to porous calcium phosphate cement.

We conducted an in vivo experiment to evaluate the resorption rate of a calcium phosphate cement (CPC) with macropores larger than 100 microm, using the CPC called Biocement D (Merck Biomaterial, Darmstadt, Germany), which after setting only shows pores smaller than 1 microm. The gas bubble method used during the setting process created macroporosity. Preset nonporous and porous cement implants were inserted into the trabecular bone of the tibial metaphysis of goats. The size of the preset implants was 6 mm and the diameter of the drill hole was 6.3 mm, leaving a gap of 0.3 mm between implant surface and drill wall. After 2 and 10 weeks, the animals were euthanized and cement implants with surrounding bone were retrieved for histologic evaluation. Light microscopy at 2 weeks revealed that the nonporous implants were surrounded by connective tissue. On the cement surface, we observed a monolayer of multinucleated cells. Ten weeks after implantation, the nonporous implants were still surrounded by connective tissue. However, a thin layer of bone now covered the implant surface. No sign of cement resorption was observed. In contrast, the porous cement evoked a completely different bone response. At 2 weeks, bone formation had already occurred inside the implant porosity. Bone formation even appeared to occur as a result of osteoinduction. Also, at their outer surface, the porous implants were completely surrounded by bone. At 2 weeks, about 31% of the initial cement was resorbed. After 10 weeks, 81% of the initial phosphate cement was resorbed and new bone was deposited. On the basis of these observations, we conclude that the creation of macropores can significantly improve the resorption rate of CPC. This increased degradation is associated with almost complete bone replacement.

Animals↗
PubMed2004

In vivo cancellous bone remodeling on a strontium-containing hydroxyapatite (sr-HA) bioactive cement.

The purpose of this study was to investigate the in vivo bone response to the strontium-containing hydroxyapatite (Sr-HA) bioactive bone cement injected into the cancellous bone. Sr-HA cement was injected into the iliac crest of rabbits for 1, 3, and 6 months. Active bone formation and remodeling were observed after 1 month. Newly formed bone was observed to grow onto the bone cement after 3 months. Thick osteoid layer with osteoblasts formed along the bone and guided over the bone cement surface reflected the stimulating effect of Sr-HA. From scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX) analysis, high calcium and phosphorus levels were detected at the interface with a thick layer of 70 microm in width, and fusion of Sr-HA with the bone was observed. Blood vessels were found developing in remodeling sites. The affinity of bone on Sr-HA cement was increased from 73.55 +/- 3.50% after 3 months up to 85.15 +/- 2.74% after 6 months (p < 0.01). In contrast to Sr-HA cement, poly(methyl methacrylate) (PMMA) bone cement was neither osteoconductive nor bioresorbable. Results show that the Sr-HA cement is biocompatible and osteoconductive, which is suitable for use in treating osteoporotic vertebral fractures.

Animals↗
PubMed2006

Calcium carbonate-calcium phosphate mixed cement compositions for bone reconstruction.

The feasibility of making calcium carbonate-calcium phosphate (CaCO(3)-CaP) mixed cements, comprising at least 40% (w/w) CaCO(3) in the dry powder ingredients, has been demonstrated. Several original cement compositions were obtained by mixing metastable crystalline CaCO(3) phases with metastable amorphous or crystalline CaP powders in aqueous medium. The cements set within at most 1 h at 37 degrees C in atmosphere saturated with water. The hardened cement is microporous and exhibits weak compressive strength. The setting reaction appeared to be essentially related to the formation of a highly carbonated nanocrystalline apatite phase by reaction of the metastable CaP phase with part or almost all of the metastable CaCO(3) phase. The recrystallization of metastable CaP varieties led to a final cement consisting of a highly carbonated poorly crystalline apatite analogous to bone mineral associated with various amounts of vaterite and/or aragonite. The presence of controlled amounts of CaCO(3) with a higher solubility than that of the apatite formed in the well-developed CaP cements might be of interest to increase resorption rates in biomedical cement and favors its replacement by bone tissue. Cytotoxicity testing revealed excellent cytocompatibility of CaCO(3)-CaP mixed cement compositions.

Biocompatible Materials↗
PubMed2005

Cortical bone screw fixation in ionically modified apatite cements.

Hydroxyapatite cements are used in reconstruction of the face; usually in well-defined cavities where the cement can be stabilized without the need for internal fixation. A hydroxyapatite cement that could enable screw fixation and some loading therefore has considerable potential in maxillofacial reconstruction. It has been demonstrated recently that water demand of calcium phosphate cements can be reduced by ionically modifying the liquid component. This study investigated the capacity of an ionically modified precompacted apatite cement to retain self-tapping cortical bone screws. Screw pullout forces were determined in the direction of the screw long axis and perpendicular to it, using cortical bone and polymethylmethacrylate cement as a control. In bending pullout tests, measured forces to remove screws from ionically modified precompacted cement were insignificantly different from cortical bone. However, pullout forces of bone screws from hydroxyapatite cement decreased with aging time in vitro.

Bone Cements↗
PubMed2006

Augmentation of osteoporotic bone: effect of pulsed jet-lavage on injection forces, cement distribution, and push-out strength of implants.

Demographic change in the population leads to higher incidence of fragility fractures. Fracture fixation with standard implants may lead to implant cut-out due to reduced purchase. Augmentation of the bone stock with bone cements might overcome this problem. However, cancellous bone infiltration with the viscous cement dough reveals problems of fat embolism or high pressures during application of the cement. This study investigates the improved quality of bovine cancellous bone augmentation when pulsed jet-lavage is used for fat and marrow removal. Parameters such as injection forces, cement dough distribution through cannulated implants and mechanical strength of the fixation were applied for quantification. Injection of 5 mL of acrylic bone cement required significantly lower forces in the lavaged as compared to the untreated bone (50 N vs. > 300 N). Cement distribution was much more homogeneous and push-out forces significantly higher in the pretreated bone group (8.33 +/- 1.41 kN vs. 1.66 +/- 0.63 kN). The application of pulsed jet-lavage for fat removal prior to acrylic cement augmentation led to much more controlled outcomes of the augmentation. This seems to be a relevant step towards safe and efficient injection of bone cements into cancellous bone structures.

Bone Cements↗
PubMed1991

Mechanical characteristics of the stem-cement interface.

The mechanical characteristics of the interface between a metallic stem and the surrounding poly(methyl methacrylate) bone cement were determined from experimental tests and finite element analyses. Push-through-stem tests of straight and tapered titanium alloy stems, surrounded by cement columns, were performed and the resulting load-displacement behavior and strain distribution on the surface of the cement column were measured for loading, unloading, and reloading. Test geometries were modelled using nonlinear, axisymmetric, finite element analyses, which incorporated Coulomb friction elements at the titanium alloy-cement interface. Initial residual stresses, due to curing of the cement column, were modeled by thermal contraction of the cement. Good agreement was obtained between load-displacement curves and surface strains predicted from the nonlinear analysis and those obtained from experiments, when a coefficient of friction of 0.3 was assumed for the stem-cement interface. These results show that, in the absence of chemical adhesion, the load-displacement behavior of a stem-cement composite can be described completely in terms of the friction at the interface and the residual stresses normal to the interface.

Animals↗