Cementing with poly(methyl methacrylate) (PMMA) is a common means of fixing total hip prostheses. Bone cement fails mechanically, and subsequent loosening frequently requires correction via revision surgery. An initial step in optimizing bone cement properties is to establish which properties are critical to the material's in vivo performance. The objectives were to discern the critical in vivo failure mechanisms of bone cement. Fracture surfaces of bone cement specimens that failed in vivo were compared with fatigue and rapid fracture surfaces created in vitro. In vivo fracture processes of bone cement were positively identified and explained by the elucidation of PMMA fracture micromechanisms. The ex vivo fracture surfaces are remarkably similar to in vitro fatigue fracture surfaces. The fractographic data document that the primary in vivo failure mechanism of bone cement is fatigue, and the fatigue cracks grow by developing a microcraze shower damage zone. Agglomerates of BaSO4 particles can be implicated in some bone cement failures, large flaws or voids in vivo can lead to a rapid, unstable fracture, pores in the PMMA mass have a clear influence on a propagating crack, and wear of the fracture surfaces occurs, and may produce PMMA debris, exacerbating bone destruction.

Using analogies from nature, we investigated the possibility that tyrosinase-catalyzed reactions of 3,4-dihydroxyphenethylamine (dopamine) could confer water-resistant adhesive properties to semidilute solutions of the polysaccharide chitosan. Rheological measurements showed that the tyrosinase-catalyzed, and subsequent uncatalyzed, reactions lead to substantial increases in the viscosity of the chitosan solutions. Samples from these high-viscosity modified-chitosans were spread onto dry glass slides, the slides were lapped and clipped together either in air or after being submerged in water, and the bound slides were held under water for several hours. Adhesive shear strengths of over 400 kPa were observed for these modified chitosan samples, while control chitosan solutions conferred no adhesive strength (i.e., the glass slides separated in the absence of measurable forces). High viscosities and water-resistant adhesive strengths were also observed when semidilute chitosan solutions were treated with the known cross-linking agent, glutaraldehyde. Further studies indicate a relationship between the increased viscosities and water-resistant adhesion. These results demonstrate that the renewable biopolymer chitosan can be converted into a water-resistant adhesive.

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Synthetic and cadaveric bone testing showed that locking screws offer no obvious biomechanical benefit in this application.

Better understanding of mechanical properties of DES shall improve tactile skills of the interventionists during PCI and to improve criteria for DES selection in specific clinical settings.

Fracture of the poly(methyl methacrylate) bone cement mantle can lead to the loosening and ultimate failure of cemented total joint prostheses. The addition of fibers to the bone cement increases fracture resistance and may reduce, if not eliminate, in vivo fracturing. This study discusses the effect of incorporating titanium (Ti) fibers on fracture toughness. Essential characteristics of the composite bone cement included a homogeneous and uniform fiber distribution, and a minimal increase in apparent viscosity of the polymerizing cement. Ti fiber contents of 1%, 2%, and 5% by volume increased the fracture toughness over non-reinforced bone cement by up to 56%. Bone cements of two different viscosities were used as matrix material, but when reinforced with the same fiber type and content, they showed no difference in fracture toughness. Four different fiber aspect ratios (68, 125, 227, 417) were tested. At 5% fiber content, there was no statistically significant dependence of fracture toughness on fiber aspect ratio. Scanning electron microscopy revealed important toughening mechanisms such as fiber/matrix debonding, local fracture path alteration, and ductile fiber deformation and fracture. Fiber fracture was evidence that the critical fiber length was exceeded. The surfaces of the Ti fibers were rough and irregular, indicating that a high degree of mechanical interlock between matrix and fiber was likely. The energy absorption contribution of plastic deformation and ductile fracture is absent in brittle fibers, like carbon, but is a distinction of the Ti fibers used in this study.

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