Acrylic Bone Cements: The Role of Nanotechnology in Improving Osteointegration and Tunable Mechanical Properties

Abstract

Nanotechnology is an extremely powerful emerging technology, which is expected to have a substantial impact on biomedical technology, especially in tissue engineering and drug delivery. The use of nanocompounds and nanoparticles in the synthesis of improved bone cements to be applied in vertebroplasty/kyphoplasty and arthroplasty, is of great interest due to the increasing incidence of osteoporosis and osteoarthritis. This review reports new advances in the development of acrylic bone cements, using different radio-opalescent nanomaterials taking into consideration their influence on the mechanical behavior and biocompatibility of the resulting acrylic bone cement. Furthermore, other non-radiopaque nanoparticles capable of mechanically reinforcing the bone cement as well as induce osteointegration, are also reviewed. Additionally, nanoparticles used to improve the controlled release of antibiotics contained in acrylic bone cements are briefly described.

Effect of barium-coated halloysite nanotube addition on the cytocompatibility, mechanical and contrast properties of poly(methyl methacrylate) cement

“…PMMA has been the subject of continuous product development in parallel with improvements in surgical techniques 14,15. A major focus has been on the inclusion and testing of various additives or fillers designed to improve or remediate the mechanical, thermal and biological deficiencies in conventional PMMA 16,17. Researchers have studied combinations of PMMA bone cement and several micro- and nanoparticles, including barium sulfate,18 carbon nanotubes,19,20 chitosan,21 collagen,22 clays,23,24 hydroxyapatite,25,26 magnesium oxide,27 silica28,29 and silver nanoparticles30 (refer the study by Lewis17 for an extensive review of these, and other additives, and their effects on PMMA).…”

The Role of Chitosan and Graphene Oxide in Bioactive and Antibacterial Properties of Acrylic Bone Cements

“…Lack of osseointegration due to its inert nature [14]. PMMA cements are the most commonly used to bond and load transfer between the implant and the bone [14,15].…”

“…Lack of osseointegration due to its inert nature [14]. PMMA cements are the most commonly used to bond and load transfer between the implant and the bone [14,15]. The main advantage of using it is the excellent primary fixation obtained between the implant and the bone and the patient's faster recovery [16].…”

“…Therefore, fibrous tissue is encapsulated, causing instability, and movements in the bone-cement-prosthesis interface, which is considered the weak bonding zone. These micromovements can accelerate aseptic loosening, causing implant failure [14,31].…”

“…Since a substantial fixation of the ABCs to the bone depends primarily on mechanical anchorage [32], many investigations in two directions are ongoing to overcome loosening in the prosthesis. The first consists of generating bioactivity of the cement, which is a critical factor in achieving long-term stability of the implant [14], since chemical bonding is achieved between the bone and the cement, while the second consists of providing antimicrobial properties to the ABCs since infections are common in arthroplasty and also lead to septic loosening.…”