A simple method of determining the modulus of orthopedic bone cement

Higgs, W. A. J.; Lucksanasombool, P.; Higgs, R. J. E. D.; Swain, Michael V.

doi:10.1002/1097-4636(2001)58:2<188::aid-jbm1006>3.3.co;2-m

Cited by 8 publications

(17 citation statements)

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“…When centrally loaded, this will yield an area of maximum tensile stress at the center of the lower face of the plate lowering edge effects 26, 27. The utility of this testing method with bone cement has been previously evaluated and found to be in agreement with results from compressive and bending tests 25…”

Section: Introductionmentioning

confidence: 53%

“…All testing was conducted in accordance with a biaxial flexural testing protocol previously described in detail by Higgs et al25 In brief, a biaxial jig was manufactured consisting of a cylindrical support stock (with a diameter equal to the mold diameter, 28.5 mm) housing three 4.8 mm ball bearings spaced equidistant from one another along the periphery of the support stock. The diameter of the support circle was 21.4 mm (Figure 3).…”

Section: Methodsmentioning

confidence: 99%

“…These tests in isolation may not be representative of bone cement's true load‐bearing capacity in total joint arthroplasty. Accordingly, Higgs et al25 developed a biaxial flexural testing protocol where the testing specimen is evaluated under combined loading conditions (hoop, axial, and flexural loading). It was shown26 that under biaxial loading, maximum bending stresses occur at the center of test sample away from the edges and are independent of the angular orientation and the number of supports.…”

Section: Introductionmentioning

confidence: 99%

“…Kirstein and Woolley26 substantiated the biaxial theory by reporting a good agreement between a number of experimental results and the theoretical predictions of tangential strains along the concentric support circle. Furthermore, finite element analysis25 has been used to further validate the accuracy of the biaxial test theory for cement loading applications in TJR. The “biaxial modulus” can be determined using this protocol, which involves supporting a testing specimen (configured in the shape of a plate) on three or more points near its periphery and equidistant from the center portion of the specimen.…”

Section: Introductionmentioning

confidence: 99%

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Biaxial flexural modulus of antibiotic‐impregnated orthopedic bone cement

et al. 2007

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Previously reported antibiotic-impregnated cement strengths have been based on uniaxial and fatigue testing methodologies. These methods may not provide an accurate characterization of bone cement's true load-bearing capacity in total joint replacement (TJR). The present study utilized biaxial testing to report on the properties of antibiotic-impregnated cement. Test groups included: PMMA mixed with Vancomycin, Gentamicin, Tobramycin, or no antibiotic (control). In comparison to the control group, PMMA samples mixed with powdered gentamicin resulted in an increase in the mean elastic modulus by 6.50% versus a drop noted with powdered vancomycin and tobramycin by 2.65 and 1.37% respectively. The mean elastic modulus in samples containing liquid gentamicin dropped by 11.6%. This study supports the continued use of powdered antibiotics when clinically indicated, but suggest caution in the use of liquid gentamicin in TJR.

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Section: Introductionmentioning

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Biaxial flexural modulus of antibiotic‐impregnated orthopedic bone cement

et al. 2007

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“…Biaxial flexure testing has three major advantages over conventional bend testing techniques: (1) the specimen need not be polished so the sample can be tested as‐fired, (2) edge flaws do not affect experimental results, and (3) slight specimen warping is not problematic 20, 21. Recently, BFT has been used for strength and elastic modulus measurements of dental materials, bone cements, partially stabilized zirconia bioceramics, and some studies of HA 4, 5, 22–30. The goal of this research is to characterize CaP bioceramics in the presence of OBs under in vitro conditions.…”

Section: Introductionmentioning

confidence: 99%

Biaxial flexure testing of calcium phosphate bioceramics for use in tissue engineering

Meganck

Baumann

Case

et al. 2004

J Biomedical Materials Res

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This study analyzes data from 206 CaP specimens (68 HA, 70 BCP, and 68 beta-TCP) fractured via biaxial flexure testing. Specimens were divided into four groups: (a) Group I, dry; (b) Group II, wet (day 0, immersion time approximately 5-10 s); (c) Group III, after immersion in media for 21 days (day 21); and (d) Group IV, after culturing osteoblasts (OBs) on the surface for 21 days (day 21 with cells). X-ray diffraction verified the presence of minor second phases in HA and beta-TCP while BCP was a biphasic mixture of HA and beta-TCP with minor phases present. The statistical significance (p < 0.05) of differences in the measured biaxial flexure fracture strength, S, between groups was assessed via one-way ANOVA with Tukey's test. Also, a two-parameter Weibull analysis assessed the mechanical reliability of each group. Osteoblasts increase the biaxial flexure fracture strength in a statistically significant way compared to both the HA discs in Groups II and III. Scanning electron microscope examination revealed grain boundary grooving on the sintered surfaces and with thermal expansion anisotropy, likely leads to the observed rapid strength decline upon exposure to media found in Groups II, III and IV.

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Novel microcomposite implant for the controlled delivery of antibiotics in the treatment of osteomyelitis following total joint replacement

İnceoğlu

Botimer

Maskiewicz

2020

Journal Orthopaedic Research

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The objective of this study was to develop a novel microcomposite implant to be used in the treatment of osteomyelitis following total joint arthroplasty, with the dual purpose of releasing high local concentrations of antibiotic to eradicate the infection while providing adequate mechanical strength to maintain the dynamic or static spacer. Vancomycin‐loaded microcomposite implants were fabricated by incorporating drug‐loaded microparticles comprised of mesoporous silica into commonly employed polymethylmethacrylate (PMMA) bone cement, to yield a final drug loading of 10% w/w. In vitro release kinetics at 37°C were monitored by reverse‐phase high‐performance liquid chromatography, and compared to the release kinetics of current therapy implants consisting of drug alone incorporated at 10% w/w directly into PMMA bone cement. Results demonstrated a sevenfold improvement in the elution profile of microcomposite systems over current therapy implants. In vivo delivery of vancomycin to bone from microcomposite implants (70% of payload) was significantly higher than that from current therapy implants (approx. 22% of payload) and maintained significantly higher bone concentrations for up to 2 weeks duration. The elastic modulus showed no statistical difference between microcomposite implants and current standard therapy implants before drug elution, and maintenance of acceptable strength of microcomposite implants postdrug elution. These results demonstrate that we have developed a novel microcomposite spacer that will release continuously high antibiotic concentrations over a prolonged period of time, offering the possibility to eliminate infection and avoid the emergence of new resistant bacterial strains, while maintaining the requisite mechanical properties for proper space maintenance and joint fixation.

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A simple method of determining the modulus of orthopedic bone cement

Cited by 8 publications

References 0 publications

Biaxial flexural modulus of antibiotic‐impregnated orthopedic bone cement

Biaxial flexural modulus of antibiotic‐impregnated orthopedic bone cement

Biaxial flexure testing of calcium phosphate bioceramics for use in tissue engineering

Novel microcomposite implant for the controlled delivery of antibiotics in the treatment of osteomyelitis following total joint replacement

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