Mechanical and thermal properties of polymethylmethacrylate bone cement composites incorporated with hydroxyapatite and glass‐ceramic fillers

Mechanical and Bioactive Properties of PMMA Bone Cement: A Review

Over the past few decades, poly(methyl methacrylate) (PMMA) based bone cement has been clinically used extensively in orthopedics for arthroplasty and kyphoplasty, due to its biocompatibility and excellent primary fixation to the host bone. In this focused review, we discuss the use of various fillers and secondary chemical moieties to improve the bioactivity and the physicochemical properties. The viscosity of the PMMA blend formulations and working time are crucial to achieving intimate contact with the osseous tissue, which is highly sensitive to organic or inorganic fillers. Hydroxyapatite as a reinforcement resulted in compromised mechanical properties of the modified cement. The possible mechanisms of the additive- or filler-dependent strengthening or weakening of the PMMA blend are critically reviewed. The addition of layered double hydroxides with surface functionalization appears to be a promising approach to enhance the bonding of filler with the PMMA matrix. Such an approach consequently improves the mechanical properties, owing to enhanced dispersion as well as contributions from crack bridging. Finally, the use of emerging alternatives, such as nanoparticles, and the use of natural biomolecules were highlighted to improve bioactivity and antibacterial properties.

A PMMA bone cement with improved antibacterial function and flexural strength

A novel non-leaching antibacterial bone cement has been developed and evaluated. An antibacterial furanone derivative was synthesized and covalently coated onto the surface of alumina filler particles, followed by mixing into a conventional poly(methyl methacrylate) bone cement. Flexural strength and bacterial viability were used to evaluate the modified cements. Effects of coated antibacterial moiety content, coated alumina filler particle size and loading were investigated. Results showed that almost all the modified cements showed higher flexural strength (up to 10%), flexural modulus (up to 18%), and antibacterial activity (up to 67% to S. aureus and up to 84% to E. coli), as compared to original poly(methyl methacrylate) cement. Increasing antibacterial moiety and filler loading significantly enhanced antibacterial activity. On the other hand, increasing coated filler particle size decreased antibacterial activity. Increasing antibacterial moiety content and particle size did not significantly affect flexural strength and modulus. Increasing filler loading did not significantly affect flexural modulus but reduced flexural strength. Antibacterial agent leaching tests showed that it seems no leachable antibacterial component from the modified experimental cement to the surrounding environment. Within the limitations of this study, the modified poly(methyl methacrylate) bone cement may potentially be developed into a clinically useful bone cement for reducing in-surgical and post-surgical infection.

Preparation of new bio-based antibacterial acrylic bone cement via modification with a biofunctional monomer of nitrofurfuryl methacrylate

The new bio-based antibacterial p(NFMA-co-MMA) bone cement exhibits excellent antibacterial performance in the treatment of osteoporotic vertebral compression fracture.

Mechanical and degradation properties of poly(methyl methacrylate) cement/borate bioactive glass composites

Bone cement is used extensively in orthopedics to anchor prostheses to bone and fill voids. Incorporating bioactive glass into poly(methyl methacrylate) (PMMA)-based bone cement could potentially improve its effectiveness for these tasks. This study characterizes the mechanical and degradation properties of composites containing PMMA-based bone cement and particles of borate bioactive glass designated as 13-93B3. Glass particles of size 5, 33, and 100 μm were mixed with PMMA bone cement to create composites containing 20, 30, and 40 wt % glass. Composites and a bone cement control were soaked in phosphate-buffered saline. Compressive strength, Young's modulus, weight loss, water uptake, solution pH, and ionic concentrations were measured over 21 days. The compressive strengths of composites decreased over 21 days. Average Young's moduli of the composites remained below 3 GPa. Weight loss and water uptake of specimens did not exceed 2 and 6%, respectively. Boron concentrations and pH of all solutions increased over time, with higher glass weight fractions leading to higher pH values. Results demonstrated that the composite can sustain glass degradation and ionic release without compromising short-term mechanical strength.

Synthesis of a hydroxyapatite/poly(methyl methacrylate) nanocomposite using dolomite

Hydroxyapatite/poly(methyl methacrylate) (HA-PMMA) nanocomposites are extensively used in biomedical fields. Therefore, the design and development of low-cost and industrially viable novel methods are essential to synthesize HA-PMMA nanoparticles. In this letter, we report such an economical, simple and industrially applicable novel method to synthesize nanosized HA-PMMA composite particles using extensively distributed dolomite.

Bioactive poly(methyl methacrylate) for bone fixation

An efficient and specifically formulated superior hybrid of poly(methyl methacrylate) and bioactive glass as a bone fixation biomaterial.

Nanoscale chemical interaction enhances the physical properties of bioglass composites

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.