Evaluation of Bonding Stress for the Newly Suggested Bone Cement: Comparison with Currently Used PMMA through Animal Studies

Abstract

PMMA remains the most popular material of bone cement for orthopaedic surgeries. However, conventional PMMA bone cement still has some problems. For this, we suggested new composite material (BBC) consisting of hydroxyapatite (45%), chitosan (10%) and PMMA. The purpose of this study was to evaluate the bonding stress at the interface of PMMA with additives and host bone using a rabbit model. After 6, 12 weeks of operation, the bonding stresses were evaluated by measuring shear stress through push-out test. The results of the tests showed that after 6 weeks the shear stress of the BBC was 2.65±0.29MPa and the PMMA was 1.21±0.31MPa (p<0.05). However, after 12 weeks, there were no significant differences between BBC and conventional PMMA bone cement. In SEM analysis, bone surface of BBC showed higher roughness than that of conventional PMMA bone cement after push-out test. From the study we conducted, addition of HA particles and chitosan to conventional PMMA bone cement showed promising results. The BBC has clinical potential of bone substitutes replacing conventional PMMA.

Development of Synthesis and Application of High Molecular Weight Poly(Methyl Methacrylate)

“…Inadequate strength at the cement/bone interface is one of the main drawbacks of PMMA bone cement in the current orthopedic surgeries. PMMA cement strength, surface roughness properties and osteo-blast cell growth can be improved by incorporating additives such as MgO, chitosan and hydroxyapatite to PMMA [84][85][86]. Khandaker and coworkers have investigated the fracture toughness (K IC ) of bone-PMMA with nano MgO particles or micro MgO particles, finding that the K IC of bone-PMMA with nano MgO particles and bone-PMMA with micro MgO particles are much higher than the K IC of bone-PMMA [87].…”

Fabrication and Characterizations of Metallic Mg Containing PMMA-Based Partially Degradable Composite Bone Cements

“…Nevertheless, the need for improving PMMA rises since the increasing number of clinical cases indicates the risks of inadequate bone/cement interfacial strength, causing the instability of the interface or even failure of the bone bonding to cement [22][23][24][25]. The inadequate interfacial strength was attributed to the lack of osseointegration and biodegrading ability of PMMA [26][27][28]. The biodegradable Mg is proposed to modify the PMMA bone cement by preparing partially degradable PMMA/Mg composite bone cement (PMC), aiming at improving the osseointegration of PMMA bone cement by increasing the osteo-conductivity of PMMA, and enhancing the physical interlocking between the bone tissue and the porous PMMA surface formed by the degradation of Mg on the surface.…”