1
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Prins W, Cornelissen MP, Goudriaan WA, Edens MA, Amaya J, Zollinger PE, Verheyen CCPM, Ettema HB. Comparison of osteolysis around 3 different cement restrictors in total hip arthroplasty. Hip Int 2024; 34:221-227. [PMID: 38414223 DOI: 10.1177/11207000231222328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND AND AIM Several studies reported osteolysis around polyethylene glycol/polybutylene terephthalate (PEG/PBT) based femoral cement restrictors. Our goal was to evaluate and compare osteolysis around 3 different plug designs: the slow biodegradable PEG/PBT cement restrictor; the fast biodegradable gelatin cement restrictor; and the non-biodegradable polyethylene plug. PATIENTS AND METHODS In a retrospective multicentre cohort study chart data were extracted of patients who received a total hip arthroplasty between 2008 and 2012. A total of 961 hips were included. Cortical ratio between inner and outer cortices at the centre of the plug was measured on routine postoperative follow-up moments. Median follow up of all 3 hospitals was 3.5 years (1.4-7.3). The primary outcome was evidence of osteolysis (i.e. the difference in cortical ratio [CR]) on anteroposterior (AP) radiographs at final follow-up. RESULTS Progressive osteolysis was found around the PEG/PBT cement restrictor represented by a significantly increasing cortical ratio (ΔCR 0.067 (95% CI, 0.063-0.071). Distance from tip prosthesis to plug and size of the plug were found to be independent factors in predicting increased cortical ratio. CONCLUSIONS Our multicentre cohort shows increase of cortical ratio around the PEG/PBT cement restrictor which progresses over time. Physicians should be aware of this fact and are advised to intensify follow-up of patients who received this cement restrictor.
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Affiliation(s)
- Wybren Prins
- Department of Orthopaedic Surgery and Traumatology, Isala, Zwolle, Overijssel, The Netherlands
| | - Maarten P Cornelissen
- Department of Orthopaedic Surgery and Traumatology, Isala, Zwolle, Overijssel, The Netherlands
| | - W Alexander Goudriaan
- Department of Orthopaedic Surgery and Traumatology, Isala, Zwolle, Overijssel, The Netherlands
| | - Mireille A Edens
- Department Innovation and Science, Isala, Zwolle, Overijssel, The Netherlands
| | - Jeremy Amaya
- Department of Orthopaedic Surgery and Traumatology, Dijklander Hospital, Hoorn and Purmerend, Noord-Holland, The Netherlands
| | - Paul E Zollinger
- Department of Orthopaedic Surgery and Traumatology, Ziekenhuis Rivierenland, Tiel, Gelderland, The Netherlands
| | - Cees C P M Verheyen
- Department of Orthopaedic Surgery and Traumatology, Isala, Zwolle, Overijssel, The Netherlands
| | - Harmen B Ettema
- Department of Orthopaedic Surgery and Traumatology, Isala, Zwolle, Overijssel, The Netherlands
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2
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He Y, Wang Z, Wen F, Sirotin IS, Mu J, Kireev VV. MMA-based fast-curing repair materials suitable for low-temperature application. JOURNAL OF POLYMER ENGINEERING 2022. [DOI: 10.1515/polyeng-2021-0292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
In this study, the application of methyl methacrylate (MMA) resin as the binder and standard sand as the aggregate has been employed to prepare the repair materials that can be cured in the sub-zero temperature environment. For this purpose, the redox initiation system of benzoyl peroxide (BPO) and N,N-dimethyl-p-toluidine (DMPT) has been used. Subsequently, the influence of initiator and accelerator content on the compressive strength, flexural strength, curing time and other properties of the materials has been revealed. At an ambient temperature of 0 °C, with BPO = 4.5% and DMPT = 3.5%, the developed repair materials can be cured within 31 min, and the 1 h compressive strength reaches 84.6 MPa. At an ambient temperature of −25 °C, with BPO = 4% and DMPT = 5%, the repair materials can be cured within 43 min, with the 1 h compressive strength reaching 53.4 MPa. The materials can be swiftly cured at low-temperature and exhibit excellent mechanical properties, thus, confirming their suitability for extreme environments. Fourier transform infrared spectrometry (FT-IR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and other techniques have been employed to characterize the developed materials.
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Affiliation(s)
- Yashu He
- Key Laboratory of High Performance Plastics, Ministry of Education, National & Local Joint Engineering Laboratory for Synthesis Technology of High Performance Polymer , College of Chemistry, Jilin University , 2699 Qianjin Street , Changchun , 130012 , China
| | - Zhenyang Wang
- Key Laboratory of High Performance Plastics, Ministry of Education, National & Local Joint Engineering Laboratory for Synthesis Technology of High Performance Polymer , College of Chemistry, Jilin University , 2699 Qianjin Street , Changchun , 130012 , China
| | - Fengyu Wen
- Key Laboratory of High Performance Plastics, Ministry of Education, National & Local Joint Engineering Laboratory for Synthesis Technology of High Performance Polymer , College of Chemistry, Jilin University , 2699 Qianjin Street , Changchun , 130012 , China
| | - Igor S. Sirotin
- Mendeleev University of Chemical Technology of Russia , Miusskaya sq. 9 , Moscow , 125047 , Russia
| | - Jianxin Mu
- Key Laboratory of High Performance Plastics, Ministry of Education, National & Local Joint Engineering Laboratory for Synthesis Technology of High Performance Polymer , College of Chemistry, Jilin University , 2699 Qianjin Street , Changchun , 130012 , China
| | - Vyacheslav V. Kireev
- Mendeleev University of Chemical Technology of Russia , Miusskaya sq. 9 , Moscow , 125047 , Russia
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3
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Optimization of Mechanical and Setting Properties in Acrylic Bone Cements Added with Graphene Oxide. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11115185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The extended use of acrylic bone cements (ABC) in orthopedics presents some disadvantages related to the generation of high temperatures during methyl methacrylate polymerization, thermal tissue necrosis, and low mechanical properties. Both weaknesses cause an increase in costs for the health system and a decrease in the patient’s quality of life due to the prosthesis’s loosening. Materials such as graphene oxide (GO) have a reinforcing effect on ABC’s mechanical and setting properties. This article shows for the first time the interactions present between the factors sonication time and GO percentage in the liquid phase, together with the percentage of benzoyl peroxide (BPO) in the solid phase, on the mechanical and setting properties established for cements in the ISO 5833-02 standard. Optimization of the factors using a completely randomized experimental design with a factorial structure resulted in selecting nine combinations that presented an increase in compression, flexion, and the setting time and decreased the maximum temperature reached during the polymerization. All of these characteristics are desirable for improving the clinical performance of cement. Those containing 0.3 wt.% of GO were highlighted from the selected formulations because all the possible combinations of the studied factors generate desirable properties for the ABC.
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4
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Zapata MEV, Tovar CDG, Hernandez JHM. The Role of Chitosan and Graphene Oxide in Bioactive and Antibacterial Properties of Acrylic Bone Cements. Biomolecules 2020; 10:E1616. [PMID: 33265973 PMCID: PMC7760599 DOI: 10.3390/biom10121616] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/20/2020] [Accepted: 11/24/2020] [Indexed: 02/08/2023] Open
Abstract
Acrylic bone cements (ABC) are widely used in orthopedics for joint fixation, antibiotic release, and bone defect filling, among others. However, most commercially available ABCs exhibit a lack of bioactivity and are susceptible to infection after implantation. These disadvantages generate long-term loosening of the prosthesis, high morbidity, and prolonged and expensive treatments. Due to the great importance of acrylic bone cements in orthopedics, the scientific community has advanced several efforts to develop bioactive ABCs with antibacterial activity through several strategies, including the use of biodegradable materials such as chitosan (CS) and nanostructures such as graphene oxide (GO), with promising results. This paper reviews several studies reporting advantages in bioactivity and antibacterial properties after incorporating CS and GO in bone cements. Detailed information on the possible mechanisms by which these fillers confer bioactive and antibacterial properties to cements, resulting in formulations with great potential for use in orthopedics, are also a focus in the manuscript. To the best of our knowledge, this is the first systematic review that presents the improvement in biological properties with CS and GO addition in cements that we believe will contribute to the biomedical field.
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Affiliation(s)
- Mayra Eliana Valencia Zapata
- Grupo de Materiales Compuestos, Escuela de Ingeniería de Materiales, Universidad del Valle, Calle 13 # 100-00, Cali 76001, Colombia;
| | - Carlos David Grande Tovar
- Grupo de Investigación de Fotoquímica y Fotobiología, Universidad del Atlántico, Carrera 30 Número 8-49, Puerto Colombia 081008, Colombia
| | - José Herminsul Mina Hernandez
- Grupo de Materiales Compuestos, Escuela de Ingeniería de Materiales, Universidad del Valle, Calle 13 # 100-00, Cali 76001, Colombia;
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5
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Wiegand MJ, Faraci KL, Reed BE, Hasenwinkel JM. Enhancing mechanical properties of an injectable two-solution acrylic bone cement using a difunctional crosslinker. J Biomed Mater Res B Appl Biomater 2018; 107:783-790. [PMID: 30184331 DOI: 10.1002/jbm.b.34172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 04/20/2018] [Accepted: 05/08/2018] [Indexed: 11/10/2022]
Abstract
Two-solution bone cements modified with ethylene glycol-dimethacrylate (EG-DMA) as a crosslinker have been developed as an attempt to further improve the mechanical properties of acrylic bone cement. The result of this study shows that EG-DMA can increase the mechanical properties and fractional monomer conversion while preserving the thermal characteristics. The strength and bending modulus increase with EG-DMA concentrations at 5-10 vol % EG-DMA. Substituting the EG-DMA content past 10 vol % decreases the bending properties due to the effects of reduced monomer concentrations. Strengthened EG-DMA samples demonstrated an increase in ductility with noticeably different fracture surface morphologies than the control samples, indicated by microtroughs and ridge formation caused by excessive plastic strain. This work provides insight into the effect of substituting a crosslinker for MMA monomer in an injectable two-solution system and lays out the ideal concentrations of EG-DMA for superior mechanical or fractional monomer conversion properties. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B, 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 783-790, 2019.
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Affiliation(s)
- Michael J Wiegand
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, New York, 13244.,Syracuse Biomaterials Institute, Syracuse University, Syracuse, New York, 13244
| | - Kennedy L Faraci
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, New York, 13244.,Syracuse Biomaterials Institute, Syracuse University, Syracuse, New York, 13244
| | - Brittany E Reed
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, New York, 13244.,Syracuse Biomaterials Institute, Syracuse University, Syracuse, New York, 13244
| | - Julie M Hasenwinkel
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, New York, 13244.,Syracuse Biomaterials Institute, Syracuse University, Syracuse, New York, 13244
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6
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Aghyarian S, Hu X, Haddas R, Lieberman IH, Kosmopoulos V, Kim HKW, Rodrigues DC. Biomechanical behavior of novel composite PMMA-CaP bone cements in an anatomically accurate cadaveric vertebroplasty model. J Orthop Res 2017; 35:2067-2074. [PMID: 27891670 DOI: 10.1002/jor.23491] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 11/18/2016] [Indexed: 02/04/2023]
Abstract
Vertebral compression fractures are caused by many factors including trauma and osteoporosis. Osteoporosis induced fractures are a result of loss in bone mass and quality that weaken the vertebral body. Vertebroplasty and kyphoplasty, involving cement augmentation of fractured vertebrae, show promise in restoring vertebral mechanical properties. Some complications however, are reported due to the performance characteristics of commercially available bone cements. In this study, the biomechanical performance characteristics of two novel composite (PMMA-CaP) bone cements were studied using an anatomically accurate human cadaveric vertebroplasty model. The study involves mechanical testing on two functional cadaveric spinal unit (2FSU) segments which include monotonic compression and cyclical fatigue tests, treatment by direct cement injection, and microscopic visualization of sectioned vertebrae. The 2FSU segments were fractured, treated, and mechanically tested to investigate the stability provided by two novel bone cements; using readily available commercial acrylic cement as a control. Segment height and stiffness were tracked during the study to establish biomechanical performance. The 2FSU segments were successfully stabilized with all three cement groups. Stiffness values were restored to initial levels following fatigue loading. Cement interdigitation was observed with all cement groups. This study demonstrates efficient reinforcement of the fractured vertebrae through stiffness restoration. The pre-mixed composite cements were comparable to the commercial cement in their performance and interdigitative ability, thus holding promise for future clinical use. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2067-2074, 2017.
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Affiliation(s)
- Shant Aghyarian
- Biomaterials for Osseointegration and Novel Engineering Laboratory (BONE Lab), Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, 75080
| | - Xiaobang Hu
- Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Plano Hospital, Plano, Texas, 75093
| | - Ram Haddas
- Texas Back Institute Research Foundation, Plano, Texas, 75093
| | - Isador H Lieberman
- Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Plano Hospital, Plano, Texas, 75093
| | - Victor Kosmopoulos
- Department of Orthopaedic Surgery, University of North Texas Health Science Center (UNTHSC), Fort Worth, Texas, 76107.,Department of Materials Science and Engineering, University of North Texas, Denton, Texas, 76203
| | - Harry K W Kim
- Center of Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, Texas, 75219.,Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas, 75390
| | - Danieli C Rodrigues
- Biomaterials for Osseointegration and Novel Engineering Laboratory (BONE Lab), Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, 75080
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7
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Lewis G. Properties of nanofiller-loaded poly (methyl methacrylate) bone cement composites for orthopedic applications: a review. J Biomed Mater Res B Appl Biomater 2016; 105:1260-1284. [DOI: 10.1002/jbm.b.33643] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/09/2015] [Accepted: 02/12/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Gladius Lewis
- Department of Mechanical Engineering; The University of Memphis; Memphis, 316 Engineering Science Building Tennessee 38152
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8
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Two novel high performing composite PMMA-CaP cements for vertebroplasty: An ex vivo animal study. J Mech Behav Biomed Mater 2015; 50:290-8. [DOI: 10.1016/j.jmbbm.2015.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 06/16/2015] [Accepted: 06/22/2015] [Indexed: 01/12/2023]
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9
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Rodriguez LC, Palmer K, Montagner F, Rodrigues DC. A novel chlorhexidine-releasing composite bone cement: Characterization of antimicrobial effectiveness and cement strength. J BIOACT COMPAT POL 2015. [DOI: 10.1177/0883911514566130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The addition of calcium phosphate fillers or antimicrobials to bone cements seems to produce inferior materials. In this study, a two-solution bone cement composite was designed for high viscosity and high pseudoplasticity to improve injection and mitigate the risk of extravasation. By pre-mixing these cements, the fillers are incorporated into the matrix and should not detrimentally affect the performance properties. To expand the functionality of this cement system, the addition of bioactive and antimicrobial phases were explored. Brushite and chlorhexidine were used as calcium phosphate filler and the antimicrobial phase, respectively. By controlling the free radical quenching mechanism provided by the chlorhexidine molecule, it was possible to achieve high polymer conversion rates. This phenomenon led to cement strength retention while successfully preventing microbial proliferation in an environment exposed to the cement surface. Based on these results, two-solution cement composite prepared with high concentrations of brushite and chlorhexidine diacetate salt hydrate may provide an attractive bioactive and antimicrobial cement for load-bearing applications.
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Affiliation(s)
- Lucas C Rodriguez
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
| | - Kelli Palmer
- Department of Molecular and Cell Biology, University of Texas at Dallas, Richardson, TX, USA
| | - Francisco Montagner
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Danieli C Rodrigues
- Department of Bioengineering, University of Texas at Dallas, Richardson, TX, USA
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10
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Clements J, Walker G, Pentlavalli S, Dunne N. Optimisation of a two-liquid component pre-filled acrylic bone cement system: a design of experiments approach to optimise cement final properties. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:2287-2296. [PMID: 25005558 DOI: 10.1007/s10856-014-5260-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 06/16/2014] [Indexed: 06/03/2023]
Abstract
The initial composition of acrylic bone cement along with the mixing and delivery technique used can influence its final properties and therefore its clinical success in vivo. The polymerisation of acrylic bone cement is complex with a number of processes happening simultaneously. Acrylic bone cement mixing and delivery systems have undergone several design changes in their advancement, although the cement constituents themselves have remained unchanged since they were first used. This study was conducted to determine the factors that had the greatest effect on the final properties of acrylic bone cement using a pre-filled bone cement mixing and delivery system. A design of experiments (DoE) approach was used to determine the impact of the factors associated with this mixing and delivery method on the final properties of the cement produced. The DoE illustrated that all factors present within this study had a significant impact on the final properties of the cement. An optimum cement composition was hypothesised and tested. This optimum recipe produced cement with final mechanical and thermal properties within the clinical guidelines and stated by ISO 5833 (International Standard Organisation (ISO), International standard 5833: implants for surgery-acrylic resin cements, 2002), however the low setting times observed would not be clinically viable and could result in complications during the surgical technique. As a result further development would be required to improve the setting time of the cement in order for it to be deemed suitable for use in total joint replacement surgery.
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Affiliation(s)
- James Clements
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Stranmillis Road, Belfast, BT9 5AH, UK
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11
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Preparation and Characterization of Injectable Brushite Filled-Poly (Methyl Methacrylate) Bone Cement. MATERIALS 2014; 7:6779-6795. [PMID: 28788212 PMCID: PMC5456162 DOI: 10.3390/ma7096779] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/06/2014] [Accepted: 09/15/2014] [Indexed: 11/17/2022]
Abstract
Powder-liquid poly (methyl methacrylate) (PMMA) bone cements are widely utilized for augmentation of bone fractures and fixation of orthopedic implants. These cements typically have an abundance of beneficial qualities, however their lack of bioactivity allows for continued development. To enhance osseointegration and bioactivity, calcium phosphate cements prepared with hydroxyapatite, brushite or tricalcium phosphates have been introduced with rather unsuccessful results due to increased cement viscosity, poor handling and reduced mechanical performance. This has limited the use of such cements in applications requiring delivery through small cannulas and in load bearing. The goal of this study is to design an alternative cement system that can better accommodate calcium-phosphate additives while preserving cement rheological properties and performance. In the present work, a number of brushite-filled two-solution bone cements were prepared and characterized by studying their complex viscosity-versus-test frequency, extrusion stress, clumping tendency during injection through a syringe, extent of fill of a machined void in cortical bone analog specimens, and compressive strength. The addition of brushite into the two-solution cement formulations investigated did not affect the pseudoplastic behavior and handling properties of the materials as demonstrated by rheological experiments. Extrusion stress was observed to vary with brushite concentration with values lower or in the range of control PMMA-based cements. The materials were observed to completely fill pre-formed voids in bone analog specimens. Cement compressive strength was observed to decrease with increasing concentration of fillers; however, the materials exhibited high enough strength for consideration in load bearing applications. The results indicated that partially substituting the PMMA phase of the two-solution cement with brushite at a 40% by mass concentration provided the best combination of the properties investigated. This alternative material may find applications in systems requiring highly injectable and viscous cements such as in the treatment of spinal fractures and bone defects.
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12
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Aghyarian S, Rodriguez LC, Chari J, Bentley E, Kosmopoulos V, Lieberman IH, Rodrigues DC. Characterization of a new composite PMMA-HA/Brushite bone cement for spinal augmentation. J Biomater Appl 2014; 29:688-98. [PMID: 25085810 DOI: 10.1177/0885328214544770] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Calcium phosphate fillers have been shown to increase cement osteoconductivity, but have caused drawbacks in cement properties. Hydroxyapatite and Brushite were introduced in an acrylic two-solution cement at varying concentrations. Novel composite bone cements were developed and characterized using rheology, injectability, and mechanical tests. It was hypothesized that the ample swelling time allowed by the premixed two-solution cement would enable thorough dispersion of the additives in the solutions, resulting in no detrimental effects after polymerization. The addition of Hydroxyapatite and Brushite both caused an increase in cement viscosity; however, these cements exhibited high shear-thinning, which facilitated injection. In gel point studies, the composite cements showed no detectable change in gel point time compared to an all-acrylic control cement. Hydroxyapatite and Brushite composite cements were observed to have high mechanical strengths even at high loads of calcium phosphate fillers. These cements showed an average compressive strength of 85 MPa and flexural strength of 65 MPa. A calcium phosphate-containing cement exhibiting a combination of high viscosity, pseudoplasticity and high mechanical strength can provide the essential bioactivity factor for osseointegration without sacrificing load-bearing capability.
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Affiliation(s)
- Shant Aghyarian
- Department of Bioengineering, University of Texas at Dallas, Texas, USA
| | - Lucas C Rodriguez
- Department of Bioengineering, University of Texas at Dallas, Texas, USA
| | - Jonathan Chari
- Department of Bioengineering, University of Texas at Dallas, Texas, USA
| | - Elizabeth Bentley
- Department of Bioengineering, University of Texas at Dallas, Texas, USA
| | - Victor Kosmopoulos
- Orthopedic Surgery Department, University of North Texas Health Science Center (UNTHSC), Texas, USA Department of Materials Science and Engineering, University of North Texas, Texas, USA
| | - Isador H Lieberman
- Scoliosis & Spine Tumor Center, Texas Back Institute, Texas Health Plano Hospital, Texas, USA
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13
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Aguirre-Soto A, Lim CH, Hwang AT, Musgrave CB, Stansbury JW. Visible-light organic photocatalysis for latent radical-initiated polymerization via 2e⁻/1H⁺ transfers: initiation with parallels to photosynthesis. J Am Chem Soc 2014; 136:7418-27. [PMID: 24786755 PMCID: PMC4046762 DOI: 10.1021/ja502441d] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Indexed: 01/18/2023]
Abstract
We report the latent production of free radicals from energy stored in a redox potential through a 2e(-)/1H(+) transfer process, analogous to energy harvesting in photosynthesis, using visible-light organic photoredox catalysis (photocatalysis) of methylene blue chromophore with a sacrificial sterically hindered amine reductant and an onium salt oxidant. This enables light-initiated free-radical polymerization to continue over extended time intervals (hours) in the dark after brief (seconds) low-intensity illumination and beyond the spatial reach of light by diffusion of the metastable leuco-methylene blue photoproduct. The present organic photoredox catalysis system functions via a 2e(-)/1H(+) shuttle mechanism, as opposed to the 1e(-) transfer process typical of organometallic-based and conventional organic multicomponent photoinitiator formulations. This prevents immediate formation of open-shell (radical) intermediates from the amine upon light absorption and enables the "storage" of light-energy without spontaneous initiation of the polymerization. Latent energy release and radical production are then controlled by the subsequent light-independent reaction (analogous to the Calvin cycle) between leuco-methylene blue and the onium salt oxidant that is responsible for regeneration of the organic methylene blue photocatalyst. This robust approach for photocatalysis-based energy harvesting and extended release in the dark enables temporally controlled redox initiation of polymer syntheses under low-intensity short exposure conditions and permits visible-light-mediated synthesis of polymers at least 1 order of magnitude thicker than achievable with conventional photoinitiated formulations and irradiation regimes.
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Affiliation(s)
- Alan Aguirre-Soto
- Department
of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave., Boulder, Colorado 80303, United
States
| | - Chern-Hooi Lim
- Department
of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave., Boulder, Colorado 80303, United
States
| | - Albert T. Hwang
- Department
of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave., Boulder, Colorado 80303, United
States
| | - Charles B. Musgrave
- Department
of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave., Boulder, Colorado 80303, United
States
| | - Jeffrey W. Stansbury
- Department
of Chemical and Biological Engineering, University of Colorado Boulder, 3415 Colorado Ave., Boulder, Colorado 80303, United
States
- Department
of Craniofacial Biology, School of Dental Medicine, University of Colorado, 12800 East 19th Ave., Aurora, Colorado 80045, United
States
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14
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Rodrigues DC, Gilbert JL, Bader RA, Hasenwinkel JM. PMMA brush-containing two-solution bone cement: preparation, characterization, and influence of composition on cement properties. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:79-89. [PMID: 24068542 DOI: 10.1007/s10856-013-5054-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 09/16/2013] [Indexed: 06/02/2023]
Abstract
Two-solution bone cement consisting of poly (methyl methacrylate) (PMMA) brushes in methyl methacrylate has been developed as an alternative to the traditional two-solution (TSBC) and powder-liquid cements. It was hypothesized that the substitution of brushes, for the entire pre-polymer phase of the cement, would permit a decrease in solution viscosity at higher polymer fractions, and allow for physical entanglements with the cement matrix. Consequently, improved cement exothermal and mechanical properties could be expected with brush addition. PMMA brushes were grafted on the surface of cross-linked PMMA nanospheres following a multi-stage synthetic strategy. Brushes exhibiting optimal molecular weight for preparation of TSBC were used for characterization of cement viscosity, flexural and compressive mechanical properties, exothermal properties and residual monomer content. Interactions between grafts and free polymer formed during free radical polymerization of the cement were evaluated based on molecular weight measurements of the cement matrix and brushes. Brush-containing cements exhibited lower viscosity at significantly higher polymer fractions in comparison to TSBC. Cements with PMMA brushes had significantly lower polymerization temperatures and residual monomer content. Measurements of molecular weight revealed the existence of a dry brush regime when using the brush compositions selected in this study, which led to a reduction in the mechanical properties of some of the compositions tested. The optimal cement viscosity and maintenance of other important cement properties achieved with addition of PMMA brushes is expected to expand the use of the two-solution cements in a range of applications.
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Affiliation(s)
- Danieli C Rodrigues
- Department of Bioengineering, University of Texas at Dallas, 800 W Campbell Road, Richardson, TX, 75080, USA,
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Matsushima R, Nam K, Shimatsu Y, Kimura T, Fujisato T, Kishida A. Decellularized dermis-polymer complex provides a platform for soft-to-hard tissue interfaces. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2013; 35:354-62. [PMID: 24411388 DOI: 10.1016/j.msec.2013.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 10/04/2013] [Accepted: 11/03/2013] [Indexed: 01/27/2023]
Abstract
To develop a soft-to-hard tissue interface, we made a decellularized dermis/poly(methyl methacrylate) (PMMA) complex by soaking the decellularized dermis in methyl methacrylate (MMA) and an initiator, and then polymerizing the MMA. The decellularized tissue was chosen because of its good biocompatibility and the easiness of suturing it, and MMA because of its hard tissue compatibility and wide use in the biomedical field. The MMA filled the cavities in the dermis and polymerized within 10 min. No leaking or polymer aggregation was observed, implying that a homogenous tissue-polymer complex had formed. The cell infiltration and the integration between the tissue and the dermis occurred in vivo, whereas the cells could not infiltrate the tissue-polymer complex. This implies that the interface tissue should possess both complex and noncomplex parts, where the cells infiltrate the noncomplex part and stop when they encounter the complex part, integrating the soft and hard tissue or hard polymer.
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Affiliation(s)
- Rie Matsushima
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Kwangwoo Nam
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan; Japan Science and Technology Agency, CREST, 7 Gobancho, Chiyoda-ku, Tokyo 102-0076, Japan
| | - Yukiko Shimatsu
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Tsuyoshi Kimura
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan; Japan Science and Technology Agency, CREST, 7 Gobancho, Chiyoda-ku, Tokyo 102-0076, Japan
| | - Toshiya Fujisato
- Department of Biomedical Engineering, Osaka Institute of Technology, 5-16-1 Omiya, Asahi-ku, Osaka 535-8585, Japan
| | - Akio Kishida
- Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, 2-3-10 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan; Japan Science and Technology Agency, CREST, 7 Gobancho, Chiyoda-ku, Tokyo 102-0076, Japan.
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Ravarian R, Zhong X, Barbeck M, Ghanaati S, Kirkpatrick CJ, Murphy CM, Schindeler A, Chrzanowski W, Dehghani F. Nanoscale chemical interaction enhances the physical properties of bioglass composites. ACS NANO 2013; 7:8469-8483. [PMID: 24001050 DOI: 10.1021/nn402157n] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Bioglasses are favorable biomaterials for bone tissue engineering; however, their applications are limited due to their brittleness. In addition, the early failure in the interface is a common problem of composites of bioglass and a polymer with high mechanical strength. This effect is due to the phase separation, nonhomogeneous mixture, nonuniform mechanical strength, and different degradation properties of two compounds. To address these issues, in this study a nanoscale interaction between poly(methyl methacrylate) (PMMA) and bioactive glass was formed via silane coupling agent (3-trimethoxysilyl)propyl methacrylate (MPMA). A monolith was produced at optimum composition from this hybrid by the sol-gel method at 50 °C with a rapid gelation time (<50 min) that possessed superior physicochemical properties compared to pure bioglass and physical mixture. For instance, the Young's modulus of bioglass was decreased 40-fold and the dissolution rate of silica was retarded 1.5-fold by integration of PMMA. Prolonged dissolution of silica fosters bone integration due to the continuous dissolution of bioactive silica. The primary osteoblast cells were well anchored and cell migration was observed on the surface of the hybrid. The in vivo studies in mice demonstrated that the integrity of the hybrids was maintained in subcutaneous implantation. They induced mainly a mononuclear phagocytic tissue reaction with a low level of inflammation, while bioglass provoked a tissue reaction with TRAP-positive multinucleated giant cells. These results demonstrated that the presence of a nanoscale interaction between bioglass and PMMA affects the properties of bioglass and broadens its potential applications for bone replacement.
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Affiliation(s)
- Roya Ravarian
- School of Chemical and Biomolecular Engineering, The University of Sydney , Sydney, NSW, Australia
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Lopes PP, Garcia MP, Fernandes MH, Fernandes MHV. Acrylic formulations containing bioactive and biodegradable fillers to be used as bone cements: properties and biocompatibility assessment. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2012; 33:1289-99. [PMID: 23827574 DOI: 10.1016/j.msec.2012.12.028] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 10/07/2012] [Accepted: 12/04/2012] [Indexed: 11/16/2022]
Abstract
The solid phase of bioactive self-curing acrylic cements was modified by different biodegradable fillers such as poly(3-hydroxybutyrate) (PHB) and its copolymer with hydroxyvalerate (PHBV). The addition of the biodegradable fillers made the cement partially degradable, which is important to allow new bone replacement and ingrowth. The thermal analysis, crystallinity, curing parameters, mechanical properties, degradation and cellular tests were studied in order to characterize the cement performance. Within this context it was verified that the incorporation of the PHBV polymer made the cement more resistant, reaching values within the range reported for typical PMMA bone cements. The results also showed that the cement filled with PHBV took up more water than the cement with PHB after 60 days, for all studied formulations. Regarding the osteoblastic cytocompatibility assessment, the inclusion of the PHBV greatly improved the biological response in both cements filled with the silicate or the borate glass, compared to the inclusion of the PHB. The importance of this novel approach resides on the combination of the properties of the cements components and the possibility of allowing bone regeneration, improving the interfaces with both the prosthesis and the bone, and leading to a new material with suitable performance for application as bone cement.
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Affiliation(s)
- P P Lopes
- Centre for Research in Ceramic and Composite Materials CICECO and Department of Ceramics and Glass Engineering, University of Aveiro, Campus Universitario de Santiago, 3810-193 Aveiro, Portugal
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An ex vivo exothermal and mechanical evaluation of two-solution bone cements in vertebroplasty. Spine J 2011; 11:432-9. [PMID: 21481652 DOI: 10.1016/j.spinee.2011.02.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 12/12/2010] [Accepted: 02/12/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Previous ex vivo studies showed that the properties of commercial cements modified for use in vertebroplasty are not optimal and are associated with several drawbacks, including high exothermic reaction, low cement viscosity and consequent extravasation, and unpredictable wait time after cement preparation. Additionally, strength and stiffness restoration are controversial varying with the cement type, volume injected, and technique used. PURPOSE To investigate maximum polymerization temperatures and mechanical performance of novel two-solution bone cement (TSBC) modified by the addition of cross-linked poly(methyl methacrylate) nanospheres (η-TSBC) and microspheres (μ-TSBC) in a cadaver vertebroplasty model in comparison to a commercially available cement (KyphX). To study the viability of application of these novel cement formulations in the treatment of vertebral compression fractures. STUDY DESIGN/SETTING Ex vivo biomechanical and exothermal evaluation of TSBCs using cadaveric vertebral bodies (VBs). METHODS Thirty-one cadaveric vertebrae (age, 74±2 years; T score, -1.5±0.5) were disarticulated. Thirteen vertebrae were assigned into three groups and instrumented with thermocouples positioned midbody along the intersection of the midsagittal and midcoronal axes, as well as along the intersection of the midsagittal axis and posterior VB wall. After equilibration at 37°C, 5 mL of cement was injected and temperatures were recorded for 1 hour. The groups were injected with η-TSBC, μ-TSBC, or KyphX. The remaining 18 vertebrae were biomechanically tested. After randomization into three groups, each specimen was fractured in compression and stabilized with 5 mL of each cement type. Each specimen was then retested in axial compression. RESULTS Temperatures in the central region of the vertebrae were significantly lower (p<.05) when injected with η-TSBC (44°C) in comparison to KyphX (75°C) and μ-TSBC (64°C). A significant difference was not detected between the pre- and postcementing strength (p>.05) of the three groups. There was no significant difference between the average values of stiffness among the cements (p>.05), however there was a significant difference between intact and treated stiffness (p<.05). CONCLUSIONS The TSBC cements decreased the local temperature within the VB while providing similar mechanical strength when compared with vertebrae treated with KyphX.
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Grafting of nanospherical PMMA brushes on cross-linked PMMA nanospheres for addition in two-solution bone cements. POLYMER 2011. [DOI: 10.1016/j.polymer.2011.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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López A, Persson C, Hilborn J, Engqvist H. Synthesis and characterization of injectable composites of poly[D,L-lactide-co-(ε-caprolactone)] reinforced with β-TCP and CaCO3 for intervertebral disk augmentation. J Biomed Mater Res B Appl Biomater 2010; 95:75-83. [DOI: 10.1002/jbm.b.31685] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lye KW, Tideman H, Merkx MAW, Jansen JA. Bone cements and their potential use in a mandibular endoprosthesis. TISSUE ENGINEERING PART B-REVIEWS 2010; 15:485-96. [PMID: 19663650 DOI: 10.1089/ten.teb.2009.0139] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Bone cement was first used in the 1950s. Since then many modifications have been made and alternatives developed to the original polymethylmethacrylate (PMMA) cement. In view of the use of bone cement in a novel mandibular endoprosthetic system, we performed a review of the current literature on this material. Different cements are described and their potential use in a mandibular endoprosthetic system discussed. The PMMA-based cements are currently the most suitable choice. Plain PMMA has the longest track record and is the default choice for the initial development phase of this system. If there is a significant risk of infection, then an antibiotic-loaded PMMA cement can be selected. However, modified PMMA cements, composite resin cements, osteoinductive calcium phosphate compounds, and cementless fixation are options that offer advantages over PMMA cements, and further research should be conducted to study their suitability.
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Affiliation(s)
- Kok Weng Lye
- Department of Oral and Maxillofacial Surgery, National Dental Centre , Singapore, Singapore.
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22
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Rodrigues DC, Gilbert JL, Hasenwinkel JM. Two-solution bone cements with cross-linked micro and nano-particles for vertebral fracture applications: Effects of zirconium dioxide content on the material and setting properties. J Biomed Mater Res B Appl Biomater 2010; 92:13-23. [DOI: 10.1002/jbm.b.31484] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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23
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Ginzburg-Turgeman R, Mandler D. Nanometric thin polymeric films based on molecularly imprinted technology: towards electrochemical sensing applications. Phys Chem Chem Phys 2010; 12:11041-50. [DOI: 10.1039/b927478b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Pseudoplasticity and setting properties of two-solution bone cement containing poly(methyl methacrylate) microspheres and nanospheres for kyphoplasty and vertebroplasty. J Biomed Mater Res B Appl Biomater 2009; 91:248-56. [DOI: 10.1002/jbm.b.31396] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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25
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Lewis G. Properties of antibiotic‐loaded acrylic bone cements for use in cemented arthroplasties: A state‐of‐the‐art review. J Biomed Mater Res B Appl Biomater 2008; 89:558-574. [DOI: 10.1002/jbm.b.31220] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Gladius Lewis
- Department of Mechanical Engineering, The University of Memphis, Memphis, Tennessee 38152
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26
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Lewis G. Alternative acrylic bone cement formulations for cemented arthroplasties: present status, key issues, and future prospects. J Biomed Mater Res B Appl Biomater 2008; 84:301-19. [PMID: 17588247 DOI: 10.1002/jbm.b.30873] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
All the commercially available plain acrylic bone cement brands that are used in cemented arthroplasties are based on poly (methyl methacrylate) and, with a few exceptions, have the same constituents. It is well known that these brands are beset with many drawbacks, such as high maximum exotherm temperature, lack of bioactivity, and volumetric shrinkage upon curing. Furthermore, concerns have been raised about a number of the constituents, such as toxicity of the activator (N,N,dimethyl-p-toluidine) and possible involvement of the radiopacifier (BaSO(4) or ZrO(2) particles) in third-body wear. Thus, over the years, many research efforts have been expended to address these drawbacks, culminating in a large number of alternative formulations, which may be grouped into 16 categories. Although there are a number of reviews of the large literature that now exists on these formulations, each covers only some of the categories and none contains a detailed discussion of the germane issues. The objective of the present work, therefore, was to present a comprehensive and critical review of the whole field. In addition to succinct descriptions of the cements in each category, there are explicative summaries of literature reports, a detailed discussion of several key issues surrounding the potential for use of these cements in cemented arthroplasties, and a presentation of numerous ideas for future studies.
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Affiliation(s)
- Gladius Lewis
- Department of Mechanical Engineering, The University of Memphis, 316 Engineering Science Building, Memphis, Tennessee 38152, USA.
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27
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Zhang H, Brown L, Blunt L. Static shear strength between polished stem and seven commercial acrylic bone cements. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2008; 19:591-9. [PMID: 17619954 DOI: 10.1007/s10856-007-3211-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Accepted: 06/06/2007] [Indexed: 05/16/2023]
Abstract
The stem-cement interface is one of the most significant sites in cemented total hip replacement and has long been implicated in failure of the whole joint system. However, shear strength at this interface has rarely been compared across a range of commercially available bone cements. The present study seeks to address this issue by carrying out a comparative study. The results indicated that the static shear strength was more dependent on cement type than cement viscosity and volume. However, both cement type and viscosity were contributory factors on porosity and micropore size in the cement surface. There was no significant difference between Simplex P and Simplex P with Tobramycin. Although the bone cements were all hand mixed in this study, the static shear strength was significantly larger than the values recorded by other researchers, and the porosity and micropore size showed much lower values. Bone cement transfer films were detected on the stem surface, typically about 4-10 mum thick. They were considered to be an important factor contributing to high friction at the stem-cement interface after initial debonding.
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Affiliation(s)
- Hongyu Zhang
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Queensgate, Huddersfield, UK.
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28
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Lewis G, Xu J, Madigan S, Towler MR. Influence of two changes in the composition of an acrylic bone cement on its handling, thermal, physical, and mechanical properties. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2007; 18:1649-58. [PMID: 17483892 DOI: 10.1007/s10856-007-3042-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2006] [Accepted: 05/05/2006] [Indexed: 05/15/2023]
Abstract
This study is a contribution to the growing body of work on the influence of changes in the composition of an acrylic bone cement on various properties of the curing and cured material. The focus is on one commercially-available acrylic bone cement brand, Surgical Simplex P, and three variants of it and a series of properties, namely, setting time, maximum exotherm temperature, activation energy and frequency factor for the polymerization reaction, diffusion coefficient for the uptake of phosphate buffered saline, at 37 degrees C, ultimate compressive strength (UCS), plane-strain fracture toughness, fatigue life (under fully-reversed tension-compression stress), hardness (H) and elastic modulus (both determined using quasi-static nanoindentation), and the variation of the storage and loss moduli with frequency of the applied force in a dynamic nanoindentation test. It was found that (a) a 68% reduction in the volume of the activator, N,N dimethyl-4-toluidine, relative to the total volume of the liquid monomer (the amounts of all the constituents in the powder and of the hydroquinone in the liquid monomer remaining unchanged) led to, for example, a significant decrease in the rate of the polymerization reaction, at 37 degrees C (c') and a significant increase in H; and (b) the elimination of the pre-polymerized poly (methyl methacrylate) beads in the powder (the amounts of all the other powder constituents and those of the liquid monomer remaining unchanged) led to, for example, a significant drop in c' and a significant increase in UCS. Thus, these findings suggest a strategy for optimizing the composition of an acrylic bone cement.
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Affiliation(s)
- G Lewis
- Department of Mechanical Engineering, The University of Memphis, Memphis, TN 38152-3180, USA.
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29
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Allen MJ, Leone KA, Hasenwinkel JM, Gilbert JL. Tissue response toin situ polymerization of a new two-solution bone cement: Evaluation in a sheep model. J Biomed Mater Res B Appl Biomater 2006; 79:441-52. [PMID: 16615074 DOI: 10.1002/jbm.b.30559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A two-solution bone cement (2-SC) was evaluated in a non-load bearing sheep model that simulated insertion of a cemented total joint replacement. A commercial powder-liquid bone cement formulation (Palacos R) was used as the control. The systemic response to the two cements was determined by monitoring changes in arterial blood pressure (ABP) and serum concentrations of methyl methacrylate monomer at intervals after insertion of the cement. The short-term tissue response to the two cements was assessed by quantifying histomorphometric parameters of new bone formation at 2, 4, and 12 weeks postsurgery. Intraoperatively, injection and pressurization of bone cement were well tolerated, with no significant changes in ABP in either group and no detectable circulating monomer in any animal. Several interesting trends were identified in the histomorphometry data. In the trabecular specimens, new bone formation immediately adjacent to the cement mantle was apparently suppressed in the first 2 weeks postsurgery, increased dramatically at 4 weeks, and then returned to baseline values by 12 weeks. This pattern was seen with both Palacos and 2-SC. In the cortical specimens, new bone formation was reduced on the endosteal surface when compared with the periosteal surface, with this effect being more noticeable at 2 and 4 weeks than at 12 weeks. There were no significant histopathological findings in either the bone or the draining lymph nodes. These data indicate that the biological response to 2-SC is substantially equivalent to that of Palacos R. Additional testing in a functional, load-bearing animal model is now recommended to more fully characterize the long-term biological response to 2-SC and to determine the mechanical performance of this new cement in vivo.
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Affiliation(s)
- Matthew J Allen
- Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, NY, USA.
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30
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Madigan S, Towler MR, Lewis G. Optimisation of the composition of an acrylic bone cement: application to relative amounts of the initiator and the activator/co-initiator in Surgical Simplex P. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2006; 17:307-11. [PMID: 16617408 DOI: 10.1007/s10856-006-8227-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2005] [Accepted: 10/21/2005] [Indexed: 05/08/2023]
Abstract
In cemented arthroplasties, the two-part self-curing acrylic bone cement is currently the only material used for anchoring the total joint replacement to the contiguous bone. In virtually all commercially available formulations of this cement, the agents used for the initiation and activation/co-initiation of the radical polymerisation reaction are benzoyl peroxide (BPO) and N, N dimethyl-para-toluidine (DMPT), respectively. There are no reports in the open literature on the rationale for the amounts of these and other constituents in the formulations of the cement. Given the concerns that have been raised in the literature regarding the effect of residual DMPT on the body, it is important to keep the starting amounts of BPO and DMPT as high and as low, respectively, as possible. In the present work, the focus is on the relative amounts of these two agents in the case of one widely used commercial formulation, Surgical Simplex(R) P. Thirty variants of this cement were formulated, covering three concentrations of the co-polymer/BPO (75%, 80%, and 85% of the mass of the powder) and DMPT amounts (ranging from 0.8 %v/v to 2.4% v/v.) The setting time (t(set)), the peak temperature reached during the cement polymerisation process (T(max)), and the ultimate compressive strength (UCS) of each of the formulations were determined in accordance with procedures specified in ISO 5833. A critical examination of all the results indicated that the optimum ratio of the concentration of the initiator (BPO embedded in the PMMA-sytrene co-polymer) to that of the activator/co-initiator (DMPT) in Surgical Simplex(R) P is 57.14 (80%w/w co-polymer + BPO per 1.4%v/v DMPT). The mean values of t(set), T(max), and UCS of this optimum formulation were determined to be 12.30 min, 68 degrees C, and 101 MPa, respectively, all of which are within the limits specified in ISO 5833. The commercially available formulation of this cement contains 2.5%v/v DMPT, while the optimum formulation, as found in the present work, has 44% less DMPT, which may translate to a smaller amount of residual DMPT that is available for elution into the periprosthetic tissue in a cemented arthroplasty, over the in vivo life of the joint replacement.
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Affiliation(s)
- S Madigan
- Materials and Surface Science Institute, University of Limerick, Limerick, Ireland
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31
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Nguyen S, Marchessault RH. Graft copolymers of methyl methacrylate and poly([R]-3-hydroxybutyrate) macromonomers as candidates for inclusion in acrylic bone cement formulations: Compression testing. J Biomed Mater Res B Appl Biomater 2006; 77:5-12. [PMID: 16206205 DOI: 10.1002/jbm.b.30430] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Graft copolymers of methyl methacrylate and biodegradable, biocompatible bacterial poly([R]-3-hydroxybutyrate) (PHB) blocks were synthesized and evaluated as possible constituents in acrylic bone cements for use in orthopaedic applications. The copolymers were produced by conventional free radical copolymerization and incorporated in one commercially available acrylic bone cement brand, Antibiotic Simplex (AKZ). Cements with formulations containing 6.7 and 13.5 wt % of PMMA-graft-PHB were prepared. The morphology of the graft copolymer particles was suggested to influence the ability of the modified cement to be processed. Formulations containing more than about 20 wt % of the graft copolymer resulted in cement doughs that, both after first preparation and several hours later, were either sandy or soft spongy in texture and, thus, would be unacceptable for use in orthopaedic applications. The morphologies of the powders and the volumetric porosity (p) and ultimate compressive strength (UCS) of the cured cements were determined. Micro computed tomography showed that the cements presented average porosities of 13.5-16.9%. It was found that, while the powder particle shape and size for the experimental cements were markedly different from those of AKZ, there was no significant difference in either p or UCS for these cements. The latter was determined to be about 85 MPa for the modified cements and 84 MPa for Antibiotic Simplex. Furthermore, the UCS of all the cements exceeded the minimum level for acrylic bone cements, as stipulated by ASTM F-451.
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Affiliation(s)
- Sophie Nguyen
- Department of Chemistry, McGill University, Montreal, Quebec, Canada
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32
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Shim JB, Warner SJ, Hasenwinkel JM, Gilbert JL. Analysis of the shelf life of a two-solution bone cement. Biomaterials 2005; 26:4181-7. [PMID: 15664645 DOI: 10.1016/j.biomaterials.2004.10.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2004] [Accepted: 10/19/2004] [Indexed: 10/26/2022]
Abstract
Two-solution bone cement consists of methyl methacrylate monomer and poly(methyl methacrylate) polymer dissolved together to yield a viscous solution. Two solutions are used such that the initiator, benzoyl peroxide (BPO), is placed in one solution and the activator, N,N, dimethyl-para-toluidine, is placed in the other. This approach to bone cement provides for a simplified use during surgery and eliminates some of the sources of porosity formation. However, the BPO-containing solution cement will spontaneously polymerize over time and will limit the useful shelf life of this component of the system. The activator-containing component is much more stable and is not as susceptible to spontaneous polymerization. In making two-solution cements, it is envisioned that antibiotics may be incorporated and that the polymer may be sterilized using gamma(gamma)-irradiation. Therefore, this study investigated the shelf life of the initiator-containing solution bone cement and studied the effects of initiator concentration, gamma-irradiation, gentamicin addition, and the role of storage temperature. Isothermal differential scanning calorimetry (Iso-DSC) techniques were used to monitor the polymerization of BPO-containing solutions. It was found that the shelf life was highly temperature dependent and followed an Arrhenius expression where refrigeration storage (4 degrees C) yielded approximately a 12-month storage time, while 70 degrees C storage results in setting in about 5-7 min. gamma-irradiation and gentamicin addition did not significantly affect the shelf life. Initiator concentration affected storage time with higher levels resulting in shorter shelf life.
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Affiliation(s)
- J B Shim
- Department of Bioengineering and Neuroscience, Syracuse University, Syracuse, NY 13244-5290, USA.
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Vijayanand PS, Unnithan CS, Penlidis A, Nanjundan S. Copolymerization of Benzoylphenyl Methacrylate with Methyl Methacrylate: Synthesis, Characterization and Determination of Monomer Reactivity Ratios. JOURNAL OF MACROMOLECULAR SCIENCE PART A-PURE AND APPLIED CHEMISTRY 2005. [DOI: 10.1081/ma-200056324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lukaszczyk J, Rmiga M, Jaszcz K, Adler HJP, Jähne E, Kaczmarek M. Evaluation of Oligo(ethylene glycol) Dimethacrylates Effects on the Properties of New Biodegradable Bone Cement Compositions. Macromol Biosci 2005; 5:64-9. [PMID: 15635717 DOI: 10.1002/mabi.200400135] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
New injectable, in situ curable liquid formulations consisting of biodegradable aliphatic polyester, i.e., poly(3-allyloxy-1,2-propylene)succinate (PSAGE), methyl methacrylate (MMA), and hydrophilic oligo(ethylene glycol) dimethacrylates (OEGDMA) were investigated. The effect of MMA/OEGDMA ratio, OEGDMA molecular weight, i.e., the length of oligooxyethylene fragments, on the maximum curing temperature, setting time, compressive strength and modulus of the cured materials as well as their hydrophilicity were examined. The latter was characterized by determination of equilibrium water content and static water contact angle. The maximum temperature during crosslinking was found to decrease with increasing OEGDMA molecular weight and decreasing MMA/OEGDMA ratio. The setting time was affected strongly by the concentration of double bonds and was rapidly shortened with its increase. The compressive strength and compressive modulus values decreased with increasing OEGDMA molecular weight and decreasing MMA/OEGDMA ratio. Poly(3-allyloxy-1,2-propylene succinate).
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Affiliation(s)
- Jan Lukaszczyk
- Silesian University of Technology, Department of Physical Chemistry and Technology of Polymers, 44-100 Gliwice, ul. M. Strzody 9, Poland.
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Nussbaum DA, Gailloud P, Murphy K. The chemistry of acrylic bone cements and implications for clinical use in image-guided therapy. J Vasc Interv Radiol 2004; 15:121-6. [PMID: 14963178 DOI: 10.1097/01.rvi.0000109394.74740.56] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
Advances in image-guided therapy for vertebral fractures and other bone-related disorders have made acrylic bone cement an integral part of the interventional armamentarium. Unfortunately, information on the properties and chemistry of these compounds is mostly published in the biomaterial sciences literature, a source with which the interventional community is generally unfamiliar. This review focuses on the chemistry of bone cement polymerization and the properties of components in polymethylmethacrylate (PMMA)-based polymers, the most commonly used bone cements in interventional procedures such as percutaneous vertebroplasty. The effects of altering the concentration of components such as methylmethacrylate monomers, PMMA beads, benzoyl peroxide activator, N,N-dimethyl-p-toluidine (DMPT) initiator, and radiopacifiers on the setting time, polymerization temperature, and compressive strength of the cement are also considered. This information will allow interventional radiologists to manipulate bone cement characteristics for specific applications and maximize the clinical potential of image-guided interventions.
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Affiliation(s)
- David A Nussbaum
- Division of Interventional Neuroradiology, the Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, Maryland 21287, USA
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Hasenwinkel JM, Lautenschlager EP, Wixson RL, Gilbert JL. Effect of initiation chemistry on the fracture toughness, fatigue strength, and residual monomer content of a novel high-viscosity, two-solution acrylic bone cement. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2002; 59:411-21. [PMID: 11774298 DOI: 10.1002/jbm.1257] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Porous-free, two-solution bone cements have been developed in our laboratory as an alternative to commercial powder/liquid formulations. Each pair of solutions consist of poly(methyl methacrylate) (PMMA) powder dissolved in methyl methacrylate (MMA) monomer, with benzoyl peroxide (BPO) added to one solution as the initiator and N,N-dimethyl-p-toluidine (DMPT) added to the other as the activator. When mixed, the solutions polymerize via a free radical reaction, which is governed by the concentrations of initiator and activator and their molar stoichiometry. Previous work by the authors has demonstrated that these two-solution cement compositions are comparable to Simplex P bone cement in polymerization exotherm, setting time, and flexural mechanical properties. This study was designed to evaluate the effect of BPO and DMPT concentrations, along with their molar ratio, on the fracture toughness, fatigue strength, and residual monomer content of the experimental compositions. The results showed that fracture toughness and fatigue strength for the solution cements were comparable to Simplex P and were not significantly affected by the BPO concentration or the BPO:DMPT molar ratio; however, the highest DMPT concentration yielded significantly lower values for both variables. Residual monomer content was significantly affected by both the individual concentrations of BPO and DMPT and their molar ratios. The two-solution cements had significantly higher residual monomer contents versus Simplex P; however, this can be attributed to their higher initial monomer concentration rather than a lower degree of conversion.
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Affiliation(s)
- Julie M Hasenwinkel
- Department of Biomedical Engineering, McCormick School of Engineering and Applied Science, Northwestern University, Evanston, Illinois 60201, USA.
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van de Belt H, Neut D, Schenk W, van Horn JR, van der Mei HC, Busscher HJ. Infection of orthopedic implants and the use of antibiotic-loaded bone cements. A review. ACTA ORTHOPAEDICA SCANDINAVICA 2001; 72:557-71. [PMID: 11817870 DOI: 10.1080/000164701317268978] [Citation(s) in RCA: 225] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Infections by bacteria are a serious complication following orthopedic implant surgery, that can usually only be cured by removing the implant, since the biofilm mode of growth of infecting bacteria on an implant surface protects the organisms from the host immune system and antibiotic therapy. Over the past few decades, attempts have been made to prevent and cure orthopedic implant infections by incorporating antibiotics in polymethylmethacrylate bone cements, in primary and revision surgery. However, the clinical efficacy of antibiotic-releasing bone cements is not accepted by all and the long-term exposure to low doses from antibiotic-releasing bone cements in patients is strongly related to the emerging threat of antibiotic resistance in medicine today. In this article, we start by reviewing the mechanisms governing the formation of an infectious biofilm on orthopedic implant materials, the release mechanisms and properties of clinically-used, antibiotic-loaded bone cements. The clinical efficacy of antibiotic-loaded bone cements is evaluated analyzing separatedly the prophylactic and therapeutic uses of these products.
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Affiliation(s)
- H van de Belt
- Department of Orthopedic Surgery, University Hospital Groningen, The Netherlands
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Higgs WA, Lucksanasombool P, Higgs RJ, Swain MV. A simple method of determining the modulus of orthopedic bone cement. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2001; 58:188-95. [PMID: 11241338 DOI: 10.1002/1097-4636(2001)58:2<188::aid-jbm1006>3.0.co;2-v] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Accurate determination of the elastic modulus of surgical bone cements is of primary importance, when evaluating the stresses within the cement mantle in Total Joint Arthroplasty. This article presents a new method of determining the modulus of surgical bone cements from the biaxial flexural test. The biaxial flexural test is not currently employed in mainstream orthopedic mechanical testing, which is surprising because most loading in orthopedic applications is biaxial in nature. Nor has this method been utilized for dental materials, even though the biaxial flexure test has been used for many years in this field. It has been demonstrated that the modulus of surgical bone cements can be determined from the biaxial flexural test, and these results are in agreement with results from compressive and bending tests.
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Affiliation(s)
- W A Higgs
- Biomaterials Science Research Unit, Department of Mechanical and Mechatronic Engineering, Faculty of Dentistry, Building J07, University of Sydney, Sydney, NSW 2006, Australia.
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Gilbert JL, Hasenwinkel JM, Wixson RL, Lautenschlager EP. A theoretical and experimental analysis of polymerization shrinkage of bone cement: A potential major source of porosity. JOURNAL OF BIOMEDICAL MATERIALS RESEARCH 2000; 52:210-8. [PMID: 10906694 DOI: 10.1002/1097-4636(200010)52:1<210::aid-jbm27>3.0.co;2-r] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A theoretical basis for understanding polymerization shrinkage of bone cement is presented based on density changes in converting monomer to polymer. Also, an experimental method, based on dilatometry and the Archimedes' principle is presented for highly precise and accurate measurement of unconstrained volumetric shrinkage of bone cement. Furthermore, a theoretical and experimental analysis of polymerization shrinkage in a constrained deformational state is presented to demonstrate that porosity can develop due to shrinkage. Six bone-cement conditions (Simplex-Ptrade mark vacuum and hand mixed, Endurancetrade mark vacuum mixed, and three two-solution experimental bone cements with higher initial monomer levels) were tested for volumetric shrinkage. It was found that shrinkage varied statistically (p< or = 0.05) from 5.1% (hand-mixed Simplex-Ptrade mark) to 6.7% (vacuum-mixed Simplex-Ptrade mark) to 10.5% for a 0.6:1 (polymer g/monomer mL) two-solution bone cement. Shrinkage was highly correlated with initial monomer content (R(2) = 0.912) but with a lower than theoretically expected rate. This discrepancy was due to the presence of residual monomer after polymerization. Using previously determined residual monomer levels, the theoretic shrinkage analysis was shown to be predictive of the shrinkage results with some residual monomer left after polymerization. Polymerization of a two-solution bone cement in a constrained state resulted in pores developing with volumes predicted by the theory that they are the result of shrinkage. The results of this study show that shrinkage of bone cement under certain constrained conditions may result in the development of porosity at the implant-bone cement interface and elsewhere in the polymerizing cement mantle.
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Affiliation(s)
- J L Gilbert
- Department of Bioengineering and Neuroscience, 373 Link Hall, Syracuse University, Syracuse, New York 13244, USA.
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