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Mounika C, Tadge T, Keerthana M, Velyutham R, Kapusetti G. Advancements in poly(methyl Methacrylate) bone cement for enhanced osteoconductivity and mechanical properties in vertebroplasty: A comprehensive review. Med Eng Phys 2023; 120:104049. [PMID: 37838402 DOI: 10.1016/j.medengphy.2023.104049] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/16/2023]
Abstract
The evolution of polymethyl methacrylate (PMMA) based bone cement (BC) from plexiglass to a biomaterial has revolutionized the joint and vertebral arthroplasties field. This widely used grouting material possesses exceptional properties for medical applications, including excellent biocompatibility, impressive mechanical strength, and favorable handling characteristics. PMMA-based BC is preferred in challenging conditions such as osteoporotic vertebral compression fractures, scoliosis, vertebral hemangiomas, spinal metastases, and myelomas, where it is crucial in withstanding stress. This review aims to comprehensively analyze the available reports and guide further research toward enhanced formulations of vertebral BC, focusing on its osteoconductive and mechanical properties. Furthermore, the review emphasizes the significant impact of BC's mechanical properties and osteoconductivity on the success and longevity of vertebroplasty procedures.
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Affiliation(s)
- Choppadandi Mounika
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Palaj, Gandhinagar, 382355, India
| | - Tejaswini Tadge
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Palaj, Gandhinagar, 382355, India
| | - M Keerthana
- National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Palaj, Gandhinagar, 382355, India
| | - Ravichandiran Velyutham
- National Institute of Pharmaceutical Education and Research (NIPER)-Kolkata, Bengal Chemicals, Kolkata, 700054, India
| | - Govinda Kapusetti
- National Institute of Pharmaceutical Education and Research (NIPER)-Kolkata, Bengal Chemicals, Kolkata, 700054, India.
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Robo C, Öhman-Mägi C, Persson C. Long-term mechanical properties of a novel low-modulus bone cement for the treatment of osteoporotic vertebral compression fractures. J Mech Behav Biomed Mater 2021; 118:104437. [PMID: 33706086 DOI: 10.1016/j.jmbbm.2021.104437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/20/2021] [Accepted: 02/26/2021] [Indexed: 02/04/2023]
Abstract
In spite of the success of vertebroplasty (VP) and balloon kyphoplasty (BKP), which are widely used for stabilizing painful vertebral compression fractures, concerns have been raised about use of poly(methyl methacrylate) (PMMA) bone cements for these procedures since the high compressive modulus of elasticity (E) of the cement is thought to be one of the causes of the higher number of adjacent-level vertebral fractures. Therefore, bone cements with E comparable to that of cancellous bone have been proposed. While the quasi-static compressive properties of these so-called "low-modulus" cements have been widely studied, their fatigue performance remains underassessed. The purpose of the present study was to critically compare a commercial bone cement (control cement) and its low-modulus counterpart on the basis of quasi-static compressive strength (CS), E, fatigue limit under compression-compression loading, and release of methyl methacrylate (MMA). At 24 h, mean CS and E of the low-modulus material were 72% and 77% lower than those of the control cement, whereas, at 4 weeks, mean CS and E were 60% and 54% lower, respectively. The fatigue limit of the control cement was estimated to be 43-45 MPa compared to 3-5 MPa for the low-modulus cement. The low-modulus cement showed an initial burst release of MMA after 24 h followed by a plateau, similar to many other commercially available cements, whereas the control cement showed a much lower, stable release from day 1 and up to 1 week. The low-modulus cement may be a promising alternative to currently available PMMA bone cements, with the potential for reducing the incidence of adjacent fractures following VP/BKP.
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Affiliation(s)
- Céline Robo
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden
| | - Caroline Öhman-Mägi
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden
| | - Cecilia Persson
- Division of Applied Materials Science, Department of Materials Science and Engineering, Uppsala University, Uppsala, Sweden.
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Choppadandi M, More N, Kapusetti G. Detoxification of poly(methyl methacrylate) bone cement by natural antioxidant intervention. J Biomed Mater Res A 2019; 107:2835-2847. [PMID: 31433892 DOI: 10.1002/jbm.a.36785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 12/25/2022]
Abstract
Poly(methyl methacrylate) (PMMA) bone cement is the most widely used grouting material in the joint arthroplasties and vertebroplasties. The present investigation has been carried out to scavenge the radicals and monomer by addition of an antioxidant to minimize the toxicity of bone cement (BC). The in silico studies were employed to determine the potent natural antioxidant at physiological conditions. The antioxidant methionine demonstrated a strong binding affinity with free radicals and methyl methacrylate (MMA) monomer than cysteine. The designated amount of methionine was optimized by various assay methods and >2% methionine shows strong scavenging capacity in BC. Moreover, the antioxidant-loaded BC (ABC) demonstrated similar handling, physicochemical and mechanical properties to pristine bone cement. Significantly, the developed formulation shows superior biological characteristics such as cell proliferation (2 ± 1 BC and 6 ± 1 ABC), adhesion (0.32 ± 0.02 BC and 0.54 ± 0.01 ABC), and cell viability (81 ± 2% BC and 93 ± 1% ABC) toward human osteoblast-like cells (MG-63). Therefore, the novel antioxidant bone cement is a potential candidate for various orthopedic applications to eliminate the adverse effects, related to residual toxic radical and monomer in bone cement.
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Affiliation(s)
- Mounika Choppadandi
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Ahmedabad, India
| | - Namdev More
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Ahmedabad, India
| | - Govinda Kapusetti
- Department of Medical Devices, National Institute of Pharmaceutical Education and Research (NIPER)-Ahmedabad, Ahmedabad, India
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Robo C, Öhman-Mägi C, Persson C. Compressive fatigue properties of commercially available standard and low-modulus acrylic bone cements intended for vertebroplasty. J Mech Behav Biomed Mater 2018; 82:70-76. [PMID: 29571115 DOI: 10.1016/j.jmbbm.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 12/28/2022]
Abstract
Vertebroplasty (VP) is a minimally invasive surgical procedure commonly used to relieve severe back pain associated with vertebral compression fractures. The poly(methyl methacrylate) bone cement used during this procedure is however presumed to facilitate the occurrence of additional fractures next to the treated vertebrae. A reason for this is believed to be the difference in stiffness between the bone cement and the surrounding trabecular bone. The use of bone cements with lower mechanical properties could therefore reduce the risk of complications post-surgery. While intensive research has been performed on the quasi-static mechanical properties of these cements, there is no data on their long-term mechanical properties. In the present study, the in vitro compressive fatigue performance as well as quasi-static mechanical properties of two commercially available acrylic bone cements - a low-modulus cement (Resilience®) and a standard cement (F20) from the same manufacturer - were determined. The quasi-static mechanical properties of the low-modulus and standard cements after 24 h of setting were in the range of other vertebroplastic cements (σ = 70-75 MPa; E= 1600-1900 MPa). F20 displayed similar mechanical properties over time in 37 °C phosphate buffered saline solution, while the mechanical properties of the Resilience® cement decreased gradually due to an increased porosity in the polymeric matrix. The standard cement exhibited a fatigue limit of approx. 47 MPa, whereas the low-modulus cement showed a fatigue limit of approx. 31 MPa. In summary, the low-modulus bone cement had a lower fatigue limit than the standard cement, as expected. However, this fatigue limit is still substantially higher than the stresses experienced by vertebral trabecular bone.
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Affiliation(s)
- Céline Robo
- Materials in Medicine Group, Division of Applied Materials Science, Department of Engineering Sciences, The Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - Caroline Öhman-Mägi
- Materials in Medicine Group, Division of Applied Materials Science, Department of Engineering Sciences, The Ångström Laboratory, Uppsala University, Uppsala, Sweden
| | - Cecilia Persson
- Materials in Medicine Group, Division of Applied Materials Science, Department of Engineering Sciences, The Ångström Laboratory, Uppsala University, Uppsala, Sweden.
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Ajaxon I, Holmberg A, Öhman-Mägi C, Persson C. Fatigue performance of a high-strength, degradable calcium phosphate bone cement. J Mech Behav Biomed Mater 2018; 79:46-52. [DOI: 10.1016/j.jmbbm.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/30/2017] [Accepted: 12/04/2017] [Indexed: 01/18/2023]
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DANESI VALENTINA, FALDINI CESARE, CRISTOFOLINI LUCA. METHODS FOR THE CHARACTERIZATION OF THE LONG-TERM MECHANICAL PERFORMANCE OF CEMENTS FOR VERTEBROPLASTY AND KYPHOPLASTY: CRITICAL REVIEW AND SUGGESTIONS FOR TEST METHODS. J MECH MED BIOL 2018. [DOI: 10.1142/s0219519417300022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is a growing interest towards bone cements for use in vertebroplasty and kyphoplasty, as such spine procedures are becoming more and more common. Such cements feature different compositions, including both traditional acrylic cements and resorbable and bioactive materials. Due to the different compositions and intended use, the mechanical requirements of cements for spinal applications differ from those of traditional cements used in joint replacement. Because of the great clinical implications, it is very important to assess their long-term mechanical competence in terms of fatigue strength and creep. This paper aims at offering a critical overview of the methods currently adopted for such mechanical tests. The existing international standards and guidelines and the literature were searched for publications relevant to fatigue and creep of cements for vertebroplasty and kyphoplasty. While standard methods are available for traditional bone cements in general, no standard indicates specific methods or acceptance criteria for fatigue and creep of cements for vertebroplasty and kyphoplasty. Similarly, a large number of papers were published on cements for joint replacements, but only few cover fatigue and creep of cements for vertebroplasty and kyphoplasty. Furthermore, the literature was analyzed to provide some indications of tests parameters and acceptance criteria (number of cycles, duration in time, stress levels, acceptable amount of creep) for possible tests specifically relevant to cements for spinal applications.
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Affiliation(s)
- VALENTINA DANESI
- Department of Industrial Engineering, Alma Mater Studiorum — Università di Bologna, Italy
| | - CESARE FALDINI
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum — Università di Bologna, Italy
- Department of Orthopaedics and Trauma Surgery, Università di Bologna — Istituto Ortopedico Rizzoli, Bologna, Italy
| | - LUCA CRISTOFOLINI
- Department of Industrial Engineering, Alma Mater Studiorum — Università di Bologna, Italy
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Liang T, Gao CX, Yang L, Saijilafu, Yang HL, Luo ZP. Deterioration of the mechanical properties of calcium phosphate cements with Poly (γ-glutamic acid) and its strontium salt after in vitro degradation. J Mech Behav Biomed Mater 2017; 75:190-196. [PMID: 28750300 DOI: 10.1016/j.jmbbm.2017.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 07/16/2017] [Accepted: 07/19/2017] [Indexed: 10/19/2022]
Abstract
The mechanical reliability of calcium phosphate cements has restricted their clinical application in load-bearing locations. Although their mechanical strength can be improved using a variety of strategies, their fatigue properties are still unclear, especially after degradation. The evolutions of uniaxial compressive properties and the fatigue behavior of calcium phosphate cements incorporating poly (γ-glutamic acid) and its strontium salt after different in vitro degradation times were investigated in the present study. Compressive strength decreased from the 61.2±5.4MPa of the original specimen, to 51.1±4.4, 42.2±3.8, 36.8±2.4 and 28.9±3.2MPa following degradation for one, two, three and four weeks, respectively. Fatigue life under same loading condition also decreased with increasing degradation time. The original specimens remained intact for one million cycles (run-out) under a maximum stress of 30MPa. After degradation for one to four weeks, the specimens were able to withstand maximum stress of 20, 15, 10 and 10MPa, respectively until run-out. Defect volume fraction within the specimens increased from 0.19±0.021% of the original specimen to 0.60±0.19%, 1.09±0.04%, 2.68±0.64% and 7.18±0.34% at degradation time of one, two, three and four weeks, respectively. Therefore, we can infer that the primary cause of the deterioration of the mechanical properties was an increasing in micro defects induced by degradation, which promoted crack initiation and propagation, accelerating the final mechanical failure of the bone cement. This study provided the data required for enhancing the mechanical reliability of the calcium phosphate cements after different degradation times, which will be significant for the modification of load-bearing biodegradable bone cements to match clinical application.
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Affiliation(s)
- Ting Liang
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Chun-Xia Gao
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Lei Yang
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Saijilafu
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Hui-Lin Yang
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China
| | - Zong-Ping Luo
- Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China.
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Ajaxon I, Öhman Mägi C, Persson C. Compressive fatigue properties of an acidic calcium phosphate cement-effect of phase composition. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2017; 28:41. [PMID: 28144853 PMCID: PMC5285421 DOI: 10.1007/s10856-017-5851-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 01/10/2017] [Indexed: 06/06/2023]
Abstract
Calcium phosphate cements (CPCs) are synthetic bone grafting materials that can be used in fracture stabilization and to fill bone voids after, e.g., bone tumour excision. Currently there are several calcium phosphate-based formulations available, but their use is partly limited by a lack of knowledge of their mechanical properties, in particular their resistance to mechanical loading over longer periods of time. Furthermore, depending on, e.g., setting conditions, the end product of acidic CPCs may be mainly brushite or monetite, which have been found to behave differently under quasi-static loading. The objectives of this study were to evaluate the compressive fatigue properties of acidic CPCs, as well as the effect of phase composition on these properties. Hence, brushite cements stored for different lengths of time and with different amounts of monetite were investigated under quasi-static and dynamic compression. Both storage and brushite-to-monetite phase transformation was found to have a pronounced effect both on quasi-static compressive strength and fatigue performance of the cements, whereby a substantial phase transformation gave rise to a lower mechanical resistance. The brushite cements investigated in this study had the potential to survive 5 million cycles at a maximum compressive stress of 13 MPa. Given the limited amount of published data on fatigue properties of CPCs, this study provides an important insight into the compressive fatigue behaviour of such materials.
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Affiliation(s)
- Ingrid Ajaxon
- Materials in Medicine, Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, The Ångström Laboratory, Box 534, SE-751 21, Uppsala, Sweden
| | - Caroline Öhman Mägi
- Materials in Medicine, Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, The Ångström Laboratory, Box 534, SE-751 21, Uppsala, Sweden
| | - Cecilia Persson
- Materials in Medicine, Division of Applied Materials Science, Department of Engineering Sciences, Uppsala University, The Ångström Laboratory, Box 534, SE-751 21, Uppsala, Sweden.
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9
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López-Nájera D, Rubio-Zaragoza M, Sopena-Juncosa JJ, Alentorn-Geli E, Cugat-Bertomeu R, Fernández-Sarmiento JA, Domínguez-Pérez JM, García-Balletbó M, Primo-Capella VJ, Carrillo-Poveda JM. Effects of plasma rich in growth factors (PRGF) on biomechanical properties of Achilles tendon repair. Knee Surg Sports Traumatol Arthrosc 2016; 24:3997-4004. [PMID: 26272059 DOI: 10.1007/s00167-015-3725-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/15/2015] [Indexed: 01/07/2023]
Abstract
PURPOSE To assess the biomechanical effects of intra-tendinous injections of PRGF on the healing Achilles tendon after repair in a sheep model. METHODS Thirty sheep were randomly assigned into one of the six groups depending on the type of treatment received (PRGF or placebo) and survival time (2, 4 and 8 weeks). The Achilles tendon injury was repaired by suturing the tendinous edges employing a three-loop pulley pattern. A trans-articular external fixation system was then used for immobilization. The PRGF or placebo was administered on a weekly basis completing a maximum of three infiltrations. The force, section and tension values were compared between the operated and healthy Achilles tendons across all groups. RESULTS The PRGF-treated tendons had higher force at 8 weeks compared with the placebo group (p = 0.007). Between 2 and 4 weeks, a significant increase in force in both the PRGF-treated tendon (p = 0.0027) and placebo group (p = 0.0095) occurred. No significant differences were found for section ratio between PRGF-treated tendons and the placebo group for any of the time periods evaluated. At 2 weeks, PRGF-treated tendons had higher tension ratio compared with placebo group tendons (p = 0.0143). Both PRGF and placebo treatments significantly improved the force (p < 0.001 and p = 0.0095, respectively) and tension (p = 0.009 and p = 0.0039, respectively) ratios at 8 weeks compared with 2 weeks. CONCLUSION The application of PRGF increases Achilles tendon repair strength at 8 weeks compared with the use of placebo. The use of PRGF does not modify section and tension ratios compared with placebo at 8 weeks. The tension ratio progressively increases between 2 and 8 weeks compared with the placebo.
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Affiliation(s)
- Diego López-Nájera
- García-Cugat Foundation, Barcelona, Spain. .,Instituto Veterinario de Ortopedia y Traumatología (IVOT), Barcelona, Spain. .,Clínica Veterinaria Gramenet, Hospital Veterinari Montigalà , Av dels Banús 1, Santa Coloma de Gramenet, Barcelona, Spain.
| | - Mónica Rubio-Zaragoza
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain
| | - Joaquín J Sopena-Juncosa
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain
| | - Eduard Alentorn-Geli
- Duke Sports Sciences Institute, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Ramón Cugat-Bertomeu
- García-Cugat Foundation, Barcelona, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain.,Artroscopia GC, Hospital Quirón, Barcelona, Spain
| | - J Andrés Fernández-Sarmiento
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | - Juan M Domínguez-Pérez
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain
| | - Montserrat García-Balletbó
- García-Cugat Foundation, Barcelona, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain.,Artroscopia GC, Hospital Quirón, Barcelona, Spain
| | - Víctor J Primo-Capella
- Health Care Technology Group, Biomedical Research Networking Center Bioengineering, Biomaterials, Nanomedicine (CIBER-BBN), Valencia, Spain.,Biomechanics Institute of Valencia (IBV), Universidad Politecnica de Valencia, Valencia, Spain
| | - José M Carrillo-Poveda
- García-Cugat Foundation, Barcelona, Spain.,Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain.,CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain
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Sheafi E, Tanner K. Influence of test specimen fabrication method and cross-section configuration on tension–tension fatigue life of PMMA bone cement. J Mech Behav Biomed Mater 2015; 51:380-7. [DOI: 10.1016/j.jmbbm.2015.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
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11
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Harmata AJ, Uppuganti S, Granke M, Guelcher SA, Nyman JS. Compressive fatigue and fracture toughness behavior of injectable, settable bone cements. J Mech Behav Biomed Mater 2015; 51:345-55. [PMID: 26282077 DOI: 10.1016/j.jmbbm.2015.07.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 01/09/2023]
Abstract
Bone grafts used to repair weight-bearing tibial plateau fractures often experience cyclic loading, and there is a need for bone graft substitutes that prevent failure of fixation and subsequent morbidity. However, the specific mechanical properties required for resorbable grafts to optimize structural compatibility with native bone have yet to be established. While quasi-static tests are utilized to assess weight-bearing ability, compressive strength alone is a poor indicator of in vivo performance. In the present study, we investigated the effects of interfacial bonding on material properties under conditions that re-capitulate the cyclic loading associated with weight-bearing fractures. Dynamic compressive fatigue properties of polyurethane (PUR) composites made with either unmodified (U-) or polycaprolactone surface-modified (PCL-) 45S5 bioactive glass (BG) particles were compared to a commercially available calcium sulfate and phosphate-based (CaS/P) bone cement at physiologically relevant stresses (5-30 MPa). Fatigue resistance of PCL-BG/polymer composite was superior to that of the U-BG/polymer composite and the CaS/P cement at higher stress levels for each of the fatigue failure criteria, related to modulus, creep, and maximum displacement, and was comparable to human trabecular bone. Steady state creep and damage accumulation occurred during the fatigue life of the PCL-BG/polymer and CaS/P cement, whereas creep of U-BG/polymer primarily occurred at a low number of loading cycles. From crack propagation testing, fracture toughness or resistance to crack growth was significantly higher for the PCL-BG composite than for the other materials. Finally, the fatigue and fracture toughness properties were intermediate between those of trabecular and cortical bone. These findings highlight the potential of PCL-BG/polyurethane composites as weight-bearing bone grafts.
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Affiliation(s)
- Andrew J Harmata
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Sasidhar Uppuganti
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Mathilde Granke
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Scott A Guelcher
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, TN, USA; Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.
| | - Jeffry S Nyman
- Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN 37212, USA.
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