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At least 19 recordsLinked to original sources

PubMed1993

A study of the bioactive bone cement--bone interface: quantitative and histological evaluation.

The interface between bone and a bioactive glass cement--a mixture of bioactive glass powder and ammonium phosphate solution, previously reported on by the authors--was evaluated quantitatively and histologically. The materials tested were (1) the original bioactive glass cement (BCI cement); (2) an improved type of bioactive glass cement (BCII cement); (3) polymethylmethacrylate (PMMA) bone cement; and (4) a bioactive, apatite-wollastonite-containing, glass ceramic (A-WGC). Hardened cylindrical specimens of each cement were inserted loosely into canine femora and the interfacial shear strengths were measured using a push-out test. The interfacial strength values of the bioactive glass cements increased with prolonged implantation time. At each postimplantation time studied (8, 12, and 24 weeks), the interfacial strength value of BCI cement did not differ significantly from that of A-WGC. BCII cement interfacial strength was greater than that of BCI cement, whereas the interfacial strength of PMMA bone cement remained at a very low level throughout the study. Histological examinations revealed that direct bonding of both bioactive glass cements to bone had occurred without pathologic degradation. After 24 weeks, the defects between the bone and the bioactive glass cements had been filled with mature lamellar bone. Because the bioactive glass cement system developed by the authors, especially BCII cement, shows excellent osteoconductivity and bonds to bone tightly, we consider it to be a promising material for fixing prostheses into bone.

Animals↗

PubMed2004

Thermal analysis of bone cement polymerisation at the cement-bone interface.

The two major problems that have been reported with the use of polymethylmethacrylate (PMMA) cement are thermal necrosis of surrounding bone due to the high heat generation during polymerisation and chemical necrosis due to unreacted monomer release. Computer models have been used to study the temperature and monomer distribution after cementation. In most of these models, however, polymerisation is modelled as temperature independent and cancellous bone is modelled as a continuum. Such models thus cannot account for the expected important role of the trabecular bone micro-structure. The aim of this study is to investigate the distribution of temperature and monomer leftover at the cancellous bone-cement interface during polymerisation for a realistic trabecular bone-cement micro-structure and realistic temperature-dependent polymerisation kinetics behaviour. A 3-D computer model of a piece of bovine cancellous bone that underwent pressurization with bone-cement was generated using a micro-computed tomography scanner. This geometry was used as the basis for a finite element model and a temperature-dependent problem for bone cement polymerisation kinetics was solved to simulate the bone cement polymerisation process in the vicinity of the interface. The transient temperature field throughout the interface was calculated, along with the polymerisation fraction distribution in the cement domain. The calculations revealed that the tips of the bone trabeculae that are embedded in the cement attain temperatures much higher than the average temperature of the bone volume. A small fraction of the bone (10%) is exposed to temperatures exceeding 70 degrees C, but the exposure time to these high temperatures is limited to 50s. In the region near the bone, the cement polymerisation fraction (about 84%) is less than that in the centre (where it is reaching values of over 96%). An important finding of this study thus is the fact that the bone tissue that is subjected to the highest temperatures is also subjected to high leftover monomer concentration. Furthermore the maximum bone temperature is reached relatively early, when monomer content in the neighbouring cement is still quite high.

Animals↗

PubMed2003

Fracture characteristics of acrylic bone cement-bone composites.

In this study, the fracture properties of Perspex, acrylic bone cement prepared using a commercially available reduced pressure mixing system and a bone cement-bone composite were compared under different test conditions. The method used was the double-torsion (DT) test. The observations made from this investigation are as follows. The fracture toughness and critical crack length for Perspex significantly increased (ANOVA, p = 0.001) when tested in water compared to air. An increase in test temperature from 19 to 37 degrees C resulted in a decrease in the fracture properties in water, this reduction being also statistically significant (ANOVA, p = 0.02). The mean fracture toughness and standard deviation of CMW3 bone cement when mixed under reduced pressure was 2.19 +/- 0.11 MN m(-3/2) compared to 3.89 +/- 0.10 MN m(-3/2) for the cement-bone composite (ANOVA, p = 0.004). The crack length determined for CMW3 bone cement and the cement bone composite were 0.323 +/- 0.031 and 1.1434 +/- 0.61 mm respectively. The plateau loads of the composite material were higher than measured for the monolithic acrylic bone cement, 249.66 +/- 67.75 N compared with 140.83 +/- 6.82 N. The high level of variation recorded for the plateau loads of the bone cement bone composite is due to the orientation and volume fraction of the cancellous bone. It can be concluded from this investigation that acrylic bone cement interdigitation into the cancellous bone results in a superior material with respect to crack resistance in comparison with the bone cement as a lone entity. Therefore it is an advantage if there is sufficient cancellous bone stock available within the intermedullary canal to allow bone cement penetration to occur, for the transfer of loads during daily activity. Additionally, it is paramount that the clinician ensures that adequate pressure is applied and maintained for an appropriate time during cement injection and prosthesis insertion in order to ensure optimum cement penetration into the pore openings of the cancellous bone, thus improving the resistance of the cement mantle to fracture and ultimately improving the longevity of the joint replacement.

Animals↗

PubMed1994

Effect of bone mineral particles on the porosity of bone cement.

Bone particle-impregnated bone cement is investigated in vitro, which could be used to improve fixation between bone and cement interface by ingrowth of tissues that may replace bone particles. Inorganic bone particles (150-300 microns diameter) were mixed with regular bone cement powder by 0, 10, 20, and 30% by weight and implanted into the pre-drilled intramedullary canal (11cm long, 10mm diameter) of canine femur. A 4mm diameter, 10mm long stainless steel rod was implanted to simulate the prosthesis. The specimens were cut into 2mm thick discs transversely along the long axis of the bone and ground to examine with a confocal laser microscope. Diametral tensile strength tests were performed for the 0, 10, 20, and 30% bone particle impregnated bone cement discs without the intramedullary implant. Present results show that mixing bone particles with bone cement decreased the number of pores and porosity but increased the size of pores. The analysis of porosity distribution showed no significant difference between bone cement and bone particle-impregnated bone cement. Also, the strength of the bone particle-impregnated bone cement decreased linearly with increased amount of bone particles in spite of the decreased percent porosity. Using a bone particle-impregnated bone cement along with a pre-coated implant could be one of the solutions to the problems in the fixation of total joint arthroplasty.

Animals↗

PubMed1997

[Resorbable bone cements].

Bone cements are used to treat compression fractures, fill bone defects and improve implant fixation in osteoporotic patients through reinforcement of weak bone. When the fracture repair is complete the bone cement ideally should degrade. In general, calcium-phosphate bone cements are biodegradable and can fulfill this temporary function. Several research groups have developed calcium-phosphate bone cements in the last years which have a chemical structure similar to that of the apatite of bone. However the conditions for processing the cement intraoperatively, as well as the mechanical properties and degradation characteristic of the various products show great variations. Clinical long-term studies have not yet been reported so far. Whether these new types of bone cements fulfill all the requirements for clinical application is still not certain and remains to be determined in future studies.

Absorption↗

PubMed2001

Temperature and its effect on bone cement.

Bone cement mixing is often seen as a simple procedure, but the skill of the perioperative practitioner in mixing the cement may ultimately be the difference between the success and failure of a hip or knee joint replacement. Klaus-Dieter Kühn (2000) states: 'The nurses (together with the surgeon) have enormous influence on the quality of the cement dough produced; in the end, this will considerably influence the clinical long-term result of a cemented hip, acetabulum or cemented knee.' (Bone Cements). This process doesn't happen by default. It is the result of good education, supported by sound evidence and backed up by practical experience. This series of articles has explained every aspect of cement management, covering technique, temperature, timing, mixing equipment, the importance of reproducible cement quality and health and safety issues.

Bone Cements↗

PubMed2006

[Allergy towards bone cement].

Bone cements based on polymethylmethacrylate are typically used for fixation of artificial joints. Intolerance reactions to endoprostheses not explained by infection or mechanical failure may lead to allergological diagnostics, which mostly focuses on metal allergy. However, also bone cement components may provoke hypersensitivity reactions leading to eczema, implant loosening, or fistula formation. Elicitors of such reactions encompass acrylates and additives such as benzoyl peroxide, N,N-dimethyl-p-toluidine, hydroquinone, or antibiotics (particularly gentamicin). Upon repeated contact with bone cement components, e.g., acrylate monomers, also in medical personnel occasionally hand eczema or even asthma may develop. Therefore, in the case of suspected hypersensitivity reactions to arthroplasty, the allergological diagnostics should include bone cement components.

Bone Cements↗

PubMed2000

On fatigue lifetimes and fatigue crack growth behavior of bone cement.

Bone cement is used to develop a mechanical bond between an artificial joint and the adjacent bone tissue, and any degradation of this bond is of serious concern since it can lead to loosening and eventually malfunction of the artificial joint. In the present study, the fatigue lives and fatigue crack propagation behavior of two bone cements, CMW Type 3 and Zimmer, were investigated, and it was found that the size and distribution of pores played a major role in influencing both the fatigue crack initiation and propagation processes. The fatigue lifetimes of CMW exceeded those of Zimmer because of a lesser density of large pores. When the fatigue lifetimes were plotted as a function of Klimax, the maximum initial stress intensity factor based upon the initiating pore size, the difference in fatigue lifetimes between CMW and Zimmer bone cements was greatly reduced. The fatigue crack growth behavior of both bone cements were similar. This is a further indication that the noted differences in fatigue lifetimes were related to the size of the pore at the crack initiating site.

Journal Article↗

PubMed2002

Interfacial tensile strength between polymethylmethacrylate-based bioactive bone cements and bone.

We have developed two types of polymethylmethacrylate (PMMA)-based bioactive bone cements containing bioactive glass beads (designated GBC) or apatite-wollastonite containing glass-ceramic powder (designated AWC) as the filler. A new method was used to evaluate the bone-cement interfacial strength of these bioactive bone cements. Two types of bioactive bone cements (GBC and AWC) and PMMA cement (CMW-1) were put in a frame attached to the smooth tibial metaphyseal cortex of the rabbit and polymerized in situ. The load required to detach the cement from the bone was measured at 4, 8, and 16 weeks after implantation. The interfacial tensile strength of GBC and AWC showed significantly higher values than PMMA cement from 4 weeks, and increased with time. For GBC, strength reached a maximum value of 12.39 +/- 1.79 kgf 16 weeks after implantation. Histological examination of rabbit tibiae up to 16 weeks demonstrated no intervening layer between the bioactive bone cements and the bone, whereas fibrous tissue was observed at the interface between the PMMA cement and the bone. From this study, we conclude that PMMA-based bioactive bone cements have a relatively higher adhesiveness at the interface than the conventionally used PMMA cement, showing potential as a promising alternative.

Animals↗

PubMed1997

Influence of sterilization upon a range of properties of experimental bone cements.

Bone cement, used to fix prostheses into the bone, must be sterilized prior to implantation. Two sterilization techniques, gamma and beta radiation, were investigated, examining the influence upon molecular weight, static and dynamic mechanical characteristics and rheological properties. A number of experimental cements were studied prepared from methylmethacrylate (MMA) co-polymers, either single powders or powder blends, mixed with MMA monomer. It was found that with both gamma and beta radiation, there was a decrease in molecular weight of all powders, including a MMA/styrene co-polymer, in relation to the radiation dose. This fall in molecular weight resulted in a drop in tensile strength, Young's modulus and strain to failure of all cements tested. However, the deterioration in mechanical strength was highlighted by the dynamic testing. Fatigue lives of cements after testing in tension-tension, at 2 Hz under load control and irradiated with 25 kGy gamma radiation, displayed significant decreases. This result indicated the utmost importance of conducting such tests upon experimental bone cements prior to in vivo use. The rheological time profiles of curing cements were also found to be influenced by 25 kGy gamma radiation, with a reduction of complex viscosity after sterilization.

Journal Article↗

PubMed2003

[The injection of acrylic bone cement prevents bone collapse in the intercalar bones lacking bony support: an experimental sheep semilunar bone model].

OBJECTIVES: In a sheep semilunar bone model, we investigated whether collapse in the intercalar bones lacking bony support could be prevented by the injection of acrylic bone cement. METHODS: The study included 16 limbs of eight sheep. Preoperatively, anteroposterior and lateral views of the carpal joints in the fore limbs were obtained. The animals were divided into four groups. In group 1 (n=3) no surgical procedure was performed in the right semilunar bones, whereas the periosteum on the contralateral side was elevated (group 2; n=3). The first two groups were left as controls. In Group 3 (n=5) the left semilunar bones were filled with acrylic bone cement following decancellation of the bone, while the right semilunar bones were left decancellated (group 4; n=5). The sheep were monitored for three months. Radiographs of the carpal joints were obtained to evaluate collapse occurrence in the semilunar bones. Thereafter, the animals were sacrificed and the semilunar bones were excised for biomechanical and histological examinations. Osteonecrosis and cartilage damage were sought and resistance to compressive forces was investigated. RESULTS: Radiologically, the extent of collapse was statistically significant in the semilunar bones in group 4 (p<0.05). The use of acrylic bone cement was found to prevent collapse in group 3, with no significant difference being noted between preoperative and postoperative semilunar bone heights (p>0.05). Biomechanically, the least resistance to compressive forces was measured in group 4 (p<0.05). Histologically, cartilage damage and osteonecrosis were only seen in group 4. CONCLUSION: Our data suggest that the use of acrylic bone cement prevents collapse in the semilunar bones, without inducing any cartilage damage or osteonecrosis.

Animals↗

PubMedDate not supplied

[Adaptation of the viscoelastic behavior of bone cement to bone as a stabilizing factor in endoprostheses].

Incompatibility of viscoelastic properties is a major factor contributing to the development and enlargement of microscopic cracks between bone and bone cement. In the study reported here the viscoelastic characteristics of fresh long bones were studied in vitro and compared with those of bone cement. Using strain gauges, creep elongation was measured over time spans ranging from 10(-2) to 10(3) seconds with an applied stress of 10 MPa. On the basis of these measurements creep compliance and permanent elongation at two points on a sheep femur were calculated by means of a rheologic Kelvin model with three parameters. The possibility of obtaining an optimal bone/cement bond was studied in the light of these results and of data published in the literature on bone cement creep related to cement composition factors.

Biomechanical Phenomena↗

PubMed1999

Transmission electron microscopic study of interface between bioactive bone cement and bone: comparison of apatite and wollastonite containing glass-ceramic filler with hydroxyapatite and beta-tricalcium phosphate fillers.

We developed a bioactive bone cement that consists of apatite and wollastonite containing glass-ceramic (AW-GC) powder and bisphenol-a-glycidyl methacrylate (Bis-GMA) based resin. In this study, we made three types of cement (designated AWC, HAC, and TCPC) consisting of either AW-GC, hydroxyapatite (HA), or beta-tricalcium phosphate (beta-TCP) powder as the inorganic filler and Bis-GMA based resin as the organic matrix. These cements were implanted into rat tibiae and cured in situ. Specimens were prepared 1, 2, 4, and 8 weeks after the operation and observed using transmission electron microscopy. Each of the bone cements was in direct contact with the bone. In AWC-implanted tibiae, the uncured surface layer of Bis-GMA based resin was completely filled with newly formed bone-like tissue 2 weeks after implantation. The AW-GC particles were surrounded by bone and were in contact with bone through an apatite layer. No intervening soft tissue was seen. In HAC-implanted tibiae, it took 4 weeks for the uncured layer to completely fill with newly formed bonelike tissue. The HA particles were also in contact with bone through an apatite layer. In TCPC-implanted tibiae, it took 8 weeks for the uncured layer to fill with newly formed bone-like tissue. The new bone that formed on the TCPC was not as dense as that on the AWC or HAC, and an intervening apatite layer was not evident. Results indicated that AWC had higher bioactivity than either HAC or TCPC.

Animals↗

PubMedDate not supplied

The effect of radiation on the shear strength of acrylic bone cement.

Bone loss due to secondary neoplastic disease of bone has frequently presented the orthopedic surgeon with difficult or insoluble problems of surgical management. Local radiation is the most effective, and widely used form of therapy for this type of metastatic disease. Levels of radiation in vitro comparable to therapeutic doses, as well as levels 6 times that commonly used in vivo on patients, demonstrate no significant effect on the mechanical properties of acrylic bone cement.

Acrylic Resins↗

PubMed2001

Open wedge tibial osteotomy with acrylic bone cement as bone substitute.

We studied the results of 245 valgus producing high tibial osteotomies performed with the use of an opening wedge technique and rigid internal fixation followed by early passive and active motion of the knee. Previous studies have used iliac bone grafts or hemicollastasis held by an external fixator for opening the osteotomy. In our series the opening was obtained by a block of cement interposed in the postero-medial part of the osteotomy. This series confirms that the opening wedge osteotomy allows good accuracy for the correction. Ninety-three percent of the knees had a correction adjusted between 180 and 187 degrees for the hip-knee-ankle angle. Survivorship analysis showed an expected rate of survival, with conversion to a total knee on the end point, of 94% at 5 years, 85% at 10 years and 68% at 15 years. Conversion to a total knee arthroplasty was accomplished without difficulty in the patients who had this procedure done. We recommend opening wedge tibial osteotomy with acrylic cement bone cement as bone substitute, rigid internal fixation, and early motion for patients who undergo high tibial osteotomy.

Adult↗

PubMed2001

[Preparation of decalcified bone matrix, bone cement and bone morphogenetic protein composite].

OBJECTIVE: To investigate the most excellent composite proportion and the most convenient composite method of decalcified bone matrix (DBM), bone cement (BC) and bovine bone morphogenetic protein (bBMP) composite. METHODS: The canine DBM and the bBMP were prepared beforehand. First mix the bBMP and DBM together with the proportion of 1:25 with adsorption and directly, then add BC with different weight proportion and finally the complex material was examined by biomechanics, scan electron microscope, determination of bone inductive activity and implanted into the canine femoral defect caused by microwave-induced hyperthermia. RESULTS: The bBMP had strong bone inductive activity and had no affect for this function when combined with DBM with different method. There were irregular gaps in the composite and most of them with diameter less than 100 microns and the porosity of the composite was less than 20% when the proportion of DBM was 40%. So it was unfavorable for the new bone to form and the new blood vessels to reconstruct. The DBM and BC could not be combined together when the proportion of DBM was 80%. While the biomechanical intensity of the composite decreased and the qualities of the new bone forming and new blood vessels reconstructing improved successively when the proportion of DBM was from 50% to 75%. CONCLUSION: It is the most convenient that bBMP is combined with DBM directly while its bone inductive activity could not be affected. The composite material not only has high biomechanical intensity, but also is favorable for new bone to form and new blood vessels to reconstruct when the proportion of DBM is 50% and 60%. So it is favorable for bone repair in the places where need to bear a load. However it is also favorable for bone repair in the places where do not need to bear a load when the proportion of DBM is 75%.

Animals↗

PubMed1999

Effect of plasma-calcium-level-responsive oestradiol release from apatitic bone cement on bone mineral density in ovariectomized rats.

The effects of plasma calcium levels on oestradiol release from apatite bone cement and on the bone mineral density of ovariectomized rats have been investigated. Apatite cement was prepared from an equimolar mixture of tetracalcium phosphate, dicalcium phosphate dihydrate and 0.5% beta-oestradiol bulk powder. After subcutaneous implantation of the cement, oestradiol release in diseased rats (ovariectomized rats on a low-calcium diet) was significantly higher than in normal rats. The drug levels of recovery-model rats (ovariectomized, but on a high-calcium diet) were significantly lower than those of the diseased rats. Calcium levels in diseased rats remained low during drug release but the plasma calcium levels of the recovery-model rats increased. The areas under the plasma calcium concentration-time curves (Ca-AUCs) for the recovery-model rats were higher than those for the diseased-model rats. The plasma oestradiol concentration AUCs and the Ca-AUCs were linearly related. The body weight of the recovery-model rats increased after five days, but that of the diseased-model rats did not. The bone mass of the recovery-model rats was greater after the experiment than before. The relationship between the bone mineral density and Ca-AUC of the diseased rats suggested that bone mineral density increased with increasing Ca-AUC. The results suggest that the severity of osteoporosis in this animal model is reduced by implantation of the oestradiol-loaded apatite cement.

Animals↗

PubMed1999

Repair of segmental bone defects using bioactive bone cement: comparison with PMMA bone cement.

We developed a bioactive bone cement (BABC) that consists of apatite and wollastonite containing glass ceramic (AW-GC) powder and bisphenol-A-glycidyl dimethacrylate (Bis-GMA) based resin. In the present study, the effectiveness of the BABC for repair of segmental bone defects under load-bearing conditions was examined using a rabbit tibia model. Polymethylmethacrylate (PMMA) bone cement was used as a control. A 15-mm length of bone was resected from the middle of the shaft of the tibia, and the tibia was fixed by two Kirschner wires. The defects were replaced by cement. Each cement was used in 12 rabbits; six rabbits were sacrificed at 12 and 25 weeks after surgery, and the tibia containing the bone cement was excised and tension tested. At both the intervals studied, the failure loads of the BABC were significantly higher than those of the PMMA cement. The BABC was in direct contact with bone, whereas soft tissue was observed between the cement and bone in all PMMA cement specimens. Results indicated that the BABC was useful as a bone substitute under load-bearing conditions.

Animals↗