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At least 19 recordsLinked to original sources
PubMed1979

Methylmethacrylate metabolism in man. The hydrolysis of methylmethacrylate to methacrylic acid during total hip replacement.

Methylmethacrylate, the monomeric component of the polymethylmethacrylate cement used in orthopedic surgery, has been shown to undergo hydrolysis to methacrylic acid during hip replacement operations. Circulating levels of methacrylic acid were comparable with those of methylmethacrylate. Concentrations of both methylmethacrylate and methacrylic acid normally lay in the range 0--15 micrograms/cc. No correlation could be discerned between changes in the concentrations of methylmethacrylate and methacrylic acid, and changes in blood pressure.

Acetabulum↗
PubMed1995

Methylmethacrylate monomer produces direct relaxation of vascular smooth muscle in vitro.

Methylmethacrylate bone cement is associated with severe hypotensive reactions during surgery and anesthesia. The purpose of this in vitro study was to determine if methylmethacrylate monomer could produce hypotension by acting directly on vascular smooth muscle. Segments of human saphenous vein or rabbit thoracic aorta were cut into rings. The rings were mounted in isolated tissue chambers in order to measure isometric tension development. Methylmethacrylate monomer (methylmethacrylic acid ester) produced direct relaxation of venous or aortic rings preconstricted with either potassium ion or noradrenaline. The relaxation was concentration-dependent, occurring at concentrations from 10(-3) to 10(-1) M. The relaxation of rabbit aortic rings (preconstricted with noradrenaline) was unaffected by pre-treatment with atropine, propranolol, cimetidine, indomethacin, or methylene blue. Endothelial stripping with Triton X-100, sufficient to completely abolish acetylcholine-induced relaxation, also had little effect on methylmethacrylate-induced relaxation. Methylmethacrylate produced direct relaxation of rabbit aortic rings constricted with either potassium or noradrenaline in calcium-deficient media, and inhibited subsequent calcium-induced constriction. These results suggest that methylmethacrylate monomer may interfere with intracellular and extracellular calcium mobilization and excitation/contraction coupling in vascular smooth muscle. The direct relaxation of venous and arterial smooth muscle produced by methylmethacrylate monomer may contribute in part to the hypotension that can occur when acrylic bone cement is employed during orthopedic procedures.

Animals↗
PubMed1978

The effect of methylmethacrylate on chemotaxis of polymorphonuclear leukocytes.

The effect of methylmethacrylate on chemotaxis of polymorphonuclear leukocytes was evaluated by an in vitro method that involved migration of human leukocytes under agarose. Chemotactic factors produced during growth of Staphylococcus epidermidis, Staphylococcus aureus, and Escherichia coli remained chemotactically active in the presence of a methylmethacrylate concentration of 1.25 per cent, which was the highest tested. The methylmethacrylate also did not alter the activity of the chemotactic factor produced by zymosan activation of normal human serum. However, when methylmethacrylate was added to normal human serum prior to zymosan activation, a methylmethacrylate concentration of 0.312 per cent significantly depressed the subsequent zymosan-induced chemotactic activity and concentrations above 0.312 per cent abolished it. When methylmethacrylate was added to the polymorphonuclear leukocyte suspensions, there was significant depression of the migration of cells at a concentration of 0.312 per cent, and at concentrations of 0.625 and 1.25 per cent no leukocyte migration occurred.

Cell Migration Inhibition↗
PubMed1979

Methylmethacrylate is a mutagen for Salmonella typhimurium.

The long-term effects of exposure to monomeric methylmethacrylate have yet to be established. We have measured the toxicity and mutagenicity of methylmethacrylate for Salmonella typhimurium. At levels of thirty-four millimolar, methylmethacrylate exhibited 28 per cent of the mutagenic activity of an equimolar dose of dimethylnitrosamine. Methylmethacrylate alone exhibited toxicity to the bacteria, but when the methylmethacrylate was incubated with a rat-liver enzyme metabolizing system, mutagenesis was induced. These findings suggest that an intermediate metabolite of methylmethacrylate is mutagenic to Salmonella typhimurium.

Adhesives↗
PubMed1993

Methylmethacrylate monomer and fat content in shed blood after total joint arthroplasty.

Twenty-five patients were prospectively evaluated to quantify levels of methylmethacrylate monomer and fat in systemic blood and in shed blood after total joint arthroplasty. Levels of methylmethacrylate monomer in systemic blood were measured at intervals after insertion of the prosthesis. Levels of methylmethacrylate monomer in shed blood were measured at intervals after insertion of the drain. Levels of fat in systemic blood were measured preoperatively and 30 minutes after insertion of the prosthesis. Levels of fat in shed blood were measured 60 minutes after insertion of the drain. No significant fat or methylmethacrylate monomer was noted in systemic blood. Levels of methylmethacrylate monomer in shed blood were highest five minutes after insertion of the drain. Levels of methylmethacrylate monomer in shed blood collected from the hip were significantly lower than levels in shed blood from the knee. Levels of shed blood from the hip and knee were undetectable six hours after insertion of the drain. Shed blood from the hips and knees contained fat particles of three diameters: fat particles less than 9 microns, 9-40 microns, and greater than 40 microns. The diameter of most of the fat particles in the shed blood was less than 9 microns. Fat particles less than 40 microns in diameter will not be removed by microaggregate screen filters 40 microns in diameter.

Blood Loss, Surgical↗
PubMed1993

Cardiovascular collapse associated with the use of methylmethacrylate.

Methylmethacrylate has been used extensively in the United States since 1971 for the fixation of orthopedic prostheses. A chemical compound that generates a considerable amount of heat as it sets and hardens, it has been known to cause mild to moderate hypotension as well as cardiovascular collapse and death in some instances. Some of the purported etiologies of the untoward effects of methylmethacrylate include fat embolism, air embolism, bone marrow embolism, peripheral vasodilation, activation within the lungs of the clotting cascade, direct cardiovascular depressant effects of methylmethacrylate cement or monomer, and others. In this article, the use of methylmethacrylate in orthopedic procedures is reviewed, along with a discussion of some of the previously hypothesized causes of its side effects. Then a case report of its use in a 59-year-old woman with a pathological fracture of her left femur is presented. Finally, the implications for the anesthetist are noted, and suggested interventions to limit untoward effects with the use of methylmethacrylate are presented.

Female↗
PubMedDate not supplied

The effect of methylmethacrylate on fracture healing.

Fractures were created in the femur of dogs by dividing the midshaft with an airdriven saw. Immobilization was achieved with a four-hole compression plate. No methylmethacrylate supplementation was used in the control groups. In the three experimental groups methylmethacrylate was added to the internal fixation by placing it on the endosteal, periosteal, and both surfaces of the bone. Healing of the fractures uniformly failed to occur when methylmethacrylate was apposed to both periosteal and endosteal regions. Histologic, fluorescent, and autoradiographic studies indicated that the bone surface in contact with methylmethacrylate was necrotic and did not incorporate tetracycline or Ca-45. New bone occurred only on the surface which was not in contact with methylmethacrylate.

Animals↗
PubMed1984

The effects of filling experimental large cortical defects with methylmethacrylate.

Three studies were performed using paired cadaver femurs to determine the effectiveness of filling large lytic defects of the femur with methylmethacrylate. In the first test, the paired femurs were prepared with a 2.5 cm defect in the femoral cortex. One of the paired femur defects was then filled with methylmethacrylate, while the other femur was left unfilled. The femurs were then tested in axial loading until failure. In the second test the paired femurs were prepared in the same manner and tested in torque until failure. In the third test, one of the paired femurs was prepared with a 2.5 cm defect and filled with methylmethacrylate while the other femur was left intact. When comparing those femurs whose defect was filled with methylmethacrylate to the prepared femurs that remained untreated, a significant increase in axial load strength of approximately 50% and an increase in torque strength of approximately 70% was found. It would seem that filling large lytic defects with methylmethacrylate at the time of internal fixation would significantly increase strength in both axial and torsional loadings.

Aged↗
PubMed1986

Blood levels and half-life of methylmethacrylate after tourniquet release during knee arthroplasty.

The blood levels and the half-life of monomeric methylmethacrylate after tourniquet release were studied in nine patients with osteoarthrosis or rheumatoid arthritis of the knee joint, treated with the Townley prosthesis under spinal anesthesia. Several ventricular extrasystoles were monitored in one patient with high blood levels of monomeric methylmethacrylate (119.80 micrograms/ml). The blood levels of monomeric methylmethacrylate ranged between 0.10 and 1.44 microgram/ml in the rest of the patients. The half-life of monomeric methylmethacrylate in vivo was 47-55 min.

Aged↗
PubMed1984

The use of methylmethacrylate cement as an instantaneous fusion mass in posterior cervical fusions: a canine in vivo experimental model.

The authors previously predicted the failure of posterior cervical fusions utilizing methylmethacrylate cement as an instantaneous "fusion" mass, based on research using an in vitro canine experimental model. This report describes the results of in vivo canine studies on the same subject. Three groups of dogs had application of a posterior C4-C5 20-gauge cerclage wire and autologous iliac crest bone graft; application of a posterior C4-C5 20-gauge cerclage wire and methylmethacrylate cement; or application of a C4-C5 20-gauge cerclage wire only. This group represented the control group. The dogs were allowed to live for 3 months postoperatively, at which time they were killed and their spine fusions studied radiologically, mechanically, and histologically. Five of the bone fusions united solidly radiologically. Their flexion stability was statistically superior to the others. Histologic studies confirmed solid union of the fusion mass to the underlying bone. Four of the six methylmethacrylate fusions demonstrated cerclage wire fracture and methacrylate-bone separation by the second postoperative month. At the time the dogs were killed, their flexion stability was statistically inferior to the bone fusions and tended to be inferior to the controls as well. Histologically, fibrous tissue was noted to have grown between the methacrylate "fusion" mass and the underlying bone. This work provides a mechanical explanation for the well-known success of the traditional bony fusion. It further supports our original prediction regarding the failure of methylmethacrylate "fusions."

Animals↗
PubMed1982

The inflammatory response to secondary methylmethacrylate challenge in lens-implanted rabbits.

Polymethylmethacrylate intraocular-lens-implanted rabbits were challenged with subcutaneous polymeric or monomeric methylmethacrylate. The inflammatory response to this secondary challenge was compared to that at the site of sham procedures and to that in control rabbits never exposed to methylmethacrylate. There was a definite granulomatous inflammatory response to both polymeric and monomeric methylmethacrylate. There was, however, no secondary enhancement of this inflammatory response at the site of subcutaneous challenge or exacerbation of intraocular inflammation in lens-implanted rabbits, thus substantiating the nonimmunogenicity of methylmethacrylate.

Animals↗
PubMed1986

Failure of stabilization of the spine with methylmethacrylate. A retrospective analysis of twenty-four cases.

Twenty-four patients who had a major complication after attempted stabilization of the spine with methylmethacrylate were referred for treatment. The initial instability that necessitated stabilization was caused by a traumatic condition in fifteen of these patients and by a metastatic tumor in nine. The average length of time before failure of fixation was 208.3 days for the patients who had a traumatic condition and 193.7 days for those who had a neoplasm. In eleven patients a progressive neural deficit developed postoperatively, and in six others the recovery of neural function was possibly hindered by the cement. A deep wound infection developed in six patients, and in five of them treatment by removal of the methylmethacrylate and metal, followed by a prolonged period of cervical traction, was required. Loosening and failure of fixation was the most common complication--it occurred in twelve of the fifteen patients who had a traumatic lesion and in eight of the nine who had a neoplasm. Salvage operations that included removal of the cement and conventional bone-grafting procedures were performed in eleven of the twelve patients who had loosening associated with a traumatic lesion and in six of the eight who had loosening and a tumor. Stability was restored in every patient. Improved long-term results can be achieved by using grafts of iliac bone and triple-wire stabilization methods (a midline wiring between the spinous processes and two iliac-crest grafts, one on each side, wired to the posterior elements) instead of methacrylate in the primary treatment of traumatic injuries. The treatment of choice for instability caused by neoplastic destruction of two or more vertebral bodies includes a construct of methylmethacrylate anteriorly. However, if cement is used, early augmentation with posterior fusion of the spine and stabilization should be considered. As a rule, combined anterior and posterior stabilization is recommended for the reconstruction of a spine that is unstable due to neoplastic destruction. In general, whenever methylmethacrylate is used for spinal stabilization, it should be augmented with grafts of iliac bone to provide long-term stability.

Adult↗
PubMedDate not supplied

[Interaction of methylmethacrylate and acrylamide with the microsomal oxidation system of the rat liver].

A complex, exhibiting the maximal absorption at 385-388 nm and minimal at 414-420 nm, was formed after interaction between cytochrome P-450 and methylmethacrylate and acrylamide at 5 mM concentration. Acrylamide at concentrations higher than 6 mM induced the formation of modified type 11 differential spectra with maxima at 418 nm and minima at 385 nm. Methylmethacrylate and acrylamide stimulated utilization of NADPH and inhibited hydroxylation of 3,4-benzpyrene. Methylmethacrylate inhibited also N-demethylation of aminopyrine. After treatment of rats with the monomers activities of cytochromes P-450, b5 and NADPH-cytochrome c reductase were unaltered. Methylmethacrylate and acrylamide appear to interact with the microsomal oxidative system.

Acrylamides↗
PubMed1983

[Comparative circulatory studies during implantation of total endoprostheses using methylmethacrylate and BDF cement].

In every ten patients undergoing elective surgery for total hip prosthesis methylmethacrylate and BDF cement respectively were used for the implantation of the prosthesis. The results of the haemodynamic investigation demonstrate that improvement of the surgical procedure may reduce the incidence of haemodynamic parameters: After implantation of methylmethacrylate into the femoral shaft the arterial pressure decreased from 95.9 +/- 13 to 86 +/- 11 torr (P less than 0.05); the left ventricular stroke work index dropped from 49.9 +/- 5 to 42.1 +/- 7 g.m/m2 (P less than 0.01). While total peripheral resistance decreased slightly in the methylmethacrylate group, there was a small increase after implantation of BDF cement into the femoral shaft. In both groups, however we found a slight elevation of pulmonary vascular resistance after cement implantation into the femur. The determination of the serum concentration of the cement monomer did not yield any measurable serum concentrations. Heat production by polymerisation of BDF cement (maximum 45.8 +/- 6.5 Centigrade) was much less compared with the temperature which developed during the polymerisation of methylmethacrylate (maximum 63 +/- 16.4 Centigrade); therefore, the safety of clinical application seems to be greater with the new BDF cement.

Aged↗
PubMed1982

Methylmethacrylate reconstruction of large iliac crest bone graft donor sites.

Often full-thickness iliac crest grafts are necessary for various reconstructive procedures. Sometimes large defects remain in the donor ilium subsequent to their removal. Several complications have occurred as a result of these bony defects. Although several reports have been published regarding the repair of iliac herniae, little has been written about procedures to prevent these complications. A technique was devised to reconstruct the ilium with methylmethacrylate. After preparation of the defect, malleable retractors are bent to conform to the contour of the iliac crest. Methylmethacrylate is then packed into the mold made by the retractors. After hardening, the methylmethacrylate casting of the defect is trimmed and routine soft tissue closure is performed. This technique has been used in eight patients without any complications. The appearance of the waist and crests has been excellent; there have been no fractures or displacements of the mass of cement and there have been no infections. All these reconstructions have been mechanically stressed as all patients had well molded postoperative casts and/or braces. Reconstruction of the ilium with methylmethacrylate after removal of full-thickness grafts appears to be a reliable, safe, and easy technique based on a short-term follow-up of up to three years.

Adolescent↗