How to determine the permeability for cement infiltration of osteoporotic cancellous bone

Baroud, Gamal; Wu, John Z.; Bohner, Marc; Sponagel, S.; Steffen, Thomas

doi:10.1016/s1350-4533(02)00223-0

Cited by 52 publications

(60 citation statements)

References 8 publications

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“…Therefore, PMMA bone cement viscosity is not a constant and it has two different characteristics: (a) rheopectic (where the viscosity rises with time) and (b) pseudoplastic (where the viscosity drops with shear rate). In order to characterize the time-dependent permeability of the bone cement, the time and shear rate dependent viscosity was captured by the following power law by Baroud et al [27]: …”

Section: Pmma Viscosity Behaviormentioning

confidence: 99%

A Review of PMMA Bone Cement and Intra-Cardiac Embolism

Shridhar¹,

Chen²,

Khalil³

et al. 2016

Preprint

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Percutaneous vertebroplasty procedure is of major importance, given the significant increasing aging population and higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main features of PMMA bone cement on the heart, and the extent of influence of materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case report.

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Section: Pmma Viscosity Behaviormentioning

confidence: 99%

A Review of PMMA Bone Cement and Intra-Cardiac Embolism

Shridhar¹,

Chen²,

Khalil³

et al. 2016

Preprint

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“…7 The effect of gelatin micro-particle size in PMMA elastic modulus Fig. 8 The effect of gelatin micro-particle density in PMMA elastic modulus Eur Spine J (2013) 22:2249-2255 2253 the cylindrical core samples were taken along the superior/ inferior direction to avoid the difference caused by the direction [15]. The addition of the gelatin micro-particles did not change the surgical procedure, specifically, the cement injection time.…”

Section: Discussionmentioning

confidence: 99%

“…The porosity of the samples was defined as the sample pore volume divided by the sample volume, where the pore volume was measured as the subtraction of the dry weight from the water-submerging weight divided by the water density. The permeability test protocol was reported previously [15][16][17]. In brief, the bone core was first placed into a 10 ml syringe.…”

Section: Methodsmentioning

confidence: 99%

“…Cement infiltration through cancellous bone was under the plunger pressure at a speed of 6 cm/min. Pressure-time curves were recorded, from which the permeability was calculated using Darcy's law as [15]:…”

Section: Methodsmentioning

confidence: 99%

“…Standard procedures of attempting the prevention of leakage include adjusting the viscosity (changes the powder/liquid ratio), monitoring the injection pressure or delaying the injection time until the cement becomes more solidified [15]. Previous studies have suggested that viscosity might be manipulated by temperature and injection force [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation

et al. 2013

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Purpose This study evaluated whether or not the addition of gelatin micro-particles into the polymethyl methacrylate (PMMA) could reduce cement infiltration in cancellous bone of vertebra. Methods Gelatin micro-particles were prepared in various sizes and mixed with PMMA in different densities. Dynamic viscosity of the mixture was measured by a rotational rheometer. Fresh bovine vertebral bodies were sectioned into cylindrical samples. Permeability of the mixture through the samples was tested on a mechanical test machine, and calculated using Darcy's law. The PMMA/gelatin mixture also underwent compressive and bending tests, and their structures were examined by scanning electron microscopy. Results The cement/gelatin mixture increased the viscosity. Significant reduction of cement permeability in cancellous bone was determined after the addition of the micro-particles. Micro-particles of 2 % in density and 125-250 lm in size decreased the permeability by 1/3 without any significant change of the cement viscosity. The biomechanical strength was unchanged in compression but decreased by up to 20 % in bending. Conclusions Gelatin micro-particles significantly increased the cement viscosity, reduced the permeability in cancellous bone of vertebra, decreased the flexural strength, but did not affect the compressive strength. Although it suggested a manageable approach in vertebral augmentation, the outcome should be further verified on a cadaveric model or an animal model before the mixture could be used safely and effectively in the clinical treatment.

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Multiphasic modelling of bone‐cement injection into vertebral cancellous bone

Bleiler

Wagner

Stadelmann

et al. 2015

Numer Methods Biomed Eng

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Percutaneous vertebroplasty represents a current procedure to effectively reinforce osteoporotic bone via the injection of bone cement. This contribution considers a continuum-mechanically based modelling approach and simulation techniques to predict the cement distributions within a vertebra during injection. To do so, experimental investigations, imaging data and image processing techniques are combined and exploited to extract necessary data from high-resolution μCT image data. The multiphasic model is based on the Theory of Porous Media, providing the theoretical basis to describe within one set of coupled equations the interaction of an elastically deformable solid skeleton, of liquid bone cement and the displacement of liquid bone marrow. The simulation results are validated against an experiment, in which bone cement was injected into a human vertebra under realistic conditions. The major advantage of this comprehensive modelling approach is the fact that one can not only predict the complex cement flow within an entire vertebra but is also capable of taking into account solid deformations in a fully coupled manner. The presented work is the first step towards the ultimate and future goal of extending this framework to a clinical tool allowing for pre-operative cement distribution predictions by means of numerical simulations.

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How to determine the permeability for cement infiltration of osteoporotic cancellous bone

Cited by 52 publications

References 8 publications

A Review of PMMA Bone Cement and Intra-Cardiac Embolism

A Review of PMMA Bone Cement and Intra-Cardiac Embolism

Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation

Multiphasic modelling of bone‐cement injection into vertebral cancellous bone

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