Influence of cement viscosity on cement interdigitation and venous fat content under in vivo conditions

Breusch, Steffen; Heisel, Christian; Müller, Jens; Borchers, Tanja; Mau, Hans

doi:10.1080/00016470216320

Cited by 56 publications

(29 citation statements)

References 32 publications

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“…In the present study, this was observed once in a low-viscosity specimen. The tendency of lowviscosity cement to "take the path of least resistance into the venous system" has been dramatically demonstrated using an in vivo ovine model (Breusch et al 2002). In that study, lower-viscosity cement showed significantly less penetration of cancellous bone but a greater tendency to enter the vascular system.…”

Section: Discussionmentioning

confidence: 86%

The effect of low-viscosity cement on mantle morphology and femoral stem micromotion: A cadaver model with simulated blood flow

et al. 2006

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Background Limited data exist on the performance of low-viscosity cement in clinically realistic cadaver models.Methods Paired stem/cement/femur constructs were generated with low-viscosity and standard-viscosity cements. The constructs were created and tested under simulated in vivo conditions, for which novel techniques were developed during this study. Mantle function was quantified by stem/cortex micromotions over 10 5 cycles of "stair-climbing". Mantle morphology was determined from transverse sections.Results Penetration of low-viscosity cement was greater proximally but less distally (p = 0.02). Lowviscosity cement resulted in more stem retroversion (p = 0.04), but there was no difference in subsidence (p = 0.4). Low-viscosity cement mantles had greater fractions of non-apposed interface (p = 0.006). Fraction of non-apposed interface predicted stem retroversion (R 2 = 0.64, p = 0.002).Interpretation Low-viscosity cement resulted in inferior cement mantles. Early micromotion was reduced by better interface apposition. The greater stem retroversion of low-viscosity cement would probably lead to higher revision rates. Early stem migration is due to interface non-apposition. Techniques should be developed to reduce non-apposition of cemented interfaces.

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Section: Discussionmentioning

confidence: 86%

The effect of low-viscosity cement on mantle morphology and femoral stem micromotion: A cadaver model with simulated blood flow

et al. 2006

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“…ID Internal diameter, OD outside diameter friction in the cannula, and less than 5% of the pressure is required to force the cement to infiltrate the trabecular bone and displace the bone marrow [4,11]. Once the theoretical findings are combined with the data obtained from experimental studies that confirm that intravertebral pressure is very small, the solution seems rather obvious [4,11,14,15,26]. Since the pressure bottleneck during the injection occurs in the cannula, its geometry must be changed.…”

Section: A New Cannula To Ease Cement Injection During Vertebroplastymentioning

confidence: 78%

“…Animal studies [15], ex vivo laboratory studies [7,14], and anecdotal evidence reported in clinical studies [2,20,21] suggest that high-viscosity cements not only increase the uniformity of the cement spread pattern in the vertebral body, but they also decrease the risk of leakage. These claims and our hypotheses will, however, require further study.…”

Section: Discussionmentioning

confidence: 99%

A new cannula to ease cement injection during vertebroplasty

Baroud

Steffen

2005

Eur Spine J

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“…4,7,16 Under in vitro conditions, the use of lowviscosity cement (i.e., cement in an early-cure stage) during initial injection appears to achieve better penetration into the femoral canal than high-viscosity cement (i.e., cement in a late-cure stage). 6,8,17 Late-cure cement has achieved better results in vivo, [18][19][20] but it requires greater force to insert the implant, and the effects of increased insertion force on the bone-cement interface in vivo are unknown.…”

Section: Discussionmentioning

confidence: 99%

Timing of femoral prosthesis insertion during cemented arthroplasty: cement curing and static mechanical strength in an in vivo model

Hunt

2011

Can J Surg

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Background: Modern cementing techniques aim to fix the implanted femoral prosthesis in the medullary cavity to minimize long-term complications such as aseptic loosening. The cure stage of bone cement into which the femoral component is being inserted is an important variable that is decided at the time of surgery. Late-cure cement is more viscous than early-cure cement and requires greater force on the part of the surgeon to insert the femoral prosthesis. We compared 2 cementing techniques, femoral component insertion into early-cure cement and insertion into latecure cement, using an in vivo model to identify if cement cure stage affects the strength of the bone-cement interface. Methods:We performed bilateral hemiarthroplasties using only the femoral component in vivo on paired porcine femora. The femora were harvested and crosssectioned in preparation for strength testing. We measured bond strength by peak load required to push the femoral prosthesis and surrounding cement mantle free of the cancellous bone.Results: All radiographs showed good cement interdigitation with no evidence of radiolucent lines at the bone-cement interface. We could not differentiate the earlycure and late-cure groups on postoperative radiographs. The mean failure load for the late-cure arthroplasties was 908 N (standard deviation [SD] 420 N), whereas the mean failure load for the conjugate early-cure arthroplasties was 503 N (SD 342 N). Conclusion:Femoral component insertion into late-cure cement required significantly higher loads for push-out than femoral component insertion into early-cure cement.Contexte : Les techniques modernes de cimentage visent à fixer la prothèse fémorale implantée dans la cavité médullaire de façon à minimiser les complications à long terme comme le descellement aseptique. Le stade de la prise du ciment orthopédique dans lequel la pièce fémorale est insérée constitue une variable importante qui est déterminée au moment de l'intervention chirurgicale. Le ciment à prise lente est plus visqueux que le ciment à prise rapide et oblige le chirurgien à exercer plus de force pour insérer la prothèse fémorale. Nous avons comparé 2 techniques de cimentage, soit l'insertion de la pièce fémorale dans du ciment à prise rapide et dans du ciment à prise lente en utilisant un modèle in vivo pour déterminer si le stade de la prise du ciment a un effet sur la solidité de l'interface os-ciment.

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Influence of cement viscosity on cement interdigitation and venous fat content under in vivo conditions

Cited by 56 publications

References 32 publications

The effect of low-viscosity cement on mantle morphology and femoral stem micromotion: A cadaver model with simulated blood flow

The effect of low-viscosity cement on mantle morphology and femoral stem micromotion: A cadaver model with simulated blood flow

A new cannula to ease cement injection during vertebroplasty

Timing of femoral prosthesis insertion during cemented arthroplasty: cement curing and static mechanical strength in an in vivo model

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