Interface gap after implantation of a cemented femoral stem in pigs

Wang, Jiansheng; Franzén, Herbert; Lidgren, Lars

doi:10.3109/17453679908997799

Cited by 33 publications

(36 citation statements)

References 16 publications

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“…The linear interface gap length (12.05-25.3'%1) was similar to results found for a grit blasted stems (31.4%) cemented into human femurs [18]. Using a pig model, Wang et al [22] found gaps of 15% at the stem-cement interface. Some of the gaps found in the in vivo simulated mold could have been artifacts because gaps were most often found at the edge between the rectangular bars and the half round bars.…”

Section: Discussionsupporting

confidence: 77%

Early cementing does not increase debond energy of grit blasted interfaces

Mann

Damron

Race

et al. 2004

Journal Orthopaedic Research

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A fracture mechanics based approach was used to determine the debond energy or fracture toughness of the stem-cement interface for a variety of conditions. The goals of the study were to determine if early cementing of stems increased the debond energy of grit blasted stem-cement interfaces and ifdebond energy was dependent on mold type. Early (2 min) and late (6 min) times of cementation were considered for two different grit blasted surface finishes (I6 and 60 grit, Ra = 5.7 or 2.3 pm). Specimen fabrication was performed using a relatively simple, unconstrained rectangular mold and a mold that more closely simulated in vivo conditions. The rectangular mold was used with all components at room temperature whereas the in vivo simulated mold had a body that resembled the femoral canal in shape and was warmed to body temperature. Early cementing did not increase the debond energy using the in vivo simulated mold. Extensive porosity was found at the interface, and porosity had a strong negative effect on debond energy. When the simpler, rectangular mold was used, early cementing did result in higher debond energies, but few voids were found at the interface. It appears that porosity at the interface was the major factor affecting the debond energy. The results from this study do not support the concept that improved stem-cement interface strength can be obtained by application of the cement while it is in a low viscosity state.

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Section: Discussionsupporting

confidence: 77%

Early cementing does not increase debond energy of grit blasted interfaces

Mann

Damron

Race

et al. 2004

Journal Orthopaedic Research

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“…In addition, six strains were selected from the collection of 38 clinical bacterial strains to investigate bacterial survival in a simulated prosthesis-related interfacial gap, with a geometry closely similar to the clinical situation and made out of the different antibiotic-loaded bone cements. A model simulating the in vivo interfacial gap, 18 existing between bone cement and bone or prosthesis was recently developed. 19 Studies on combinations of antibiotics included in bone cements using this gap model could be useful to estimate the clinical value of these combinations.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial efficacy of gentamicin‐loaded acrylic bone cements with fusidic acid or clindamycin added

Neut

Hendriks

Horn

et al. 2005

Journal Orthopaedic Research

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The increasing gentamicin resistance among bacteria in septic joint arthroplasty has stimulated interest in adding a second antibiotic into gentamicin-loaded bone cement. A first aim of this in vitro study is to investigate whether addition of fusidic acid or clindamycin to gentamicinloaded bone cement has an additional antimicrobial effect against a collection of 38 clinical isolates, including 16 gentamicin-resistant strains. A modified Kirby-Bauer test, involving measurement of the inhibition zone around antibiotic-loaded bone cement discs on agar plates, was used to investigate whether adding a second antibiotic has an additional antimicrobial effect. Second, a selected number of strains was used to study their survival in an interfacial gap made in the different bone cements to mimic the gap between bone and cement as existing near a prosthesis. Gentamicinloaded bone cement had an antimicrobial activity against 58% of the 38 bacterial strains included in this study, while 68% of the strains were affected by bone cement loaded with a combination of gentamicin and clindamycin. Bone cement loaded with the combination of gentamicin and fusidic acid had antimicrobial activity against 87% of the bacterial strains. In the prosthesis-related gap model, there was a clear trend toward less bacterial survival for gentamicin-loaded bone cement after adding clindamycin or fusidic acid. Addition of clindamycin or fusidic acid into gentamicin-loaded bone cement yields an additional antimicrobial effect. The combination gentamicin and fusidic acid was effective against a higher number of clinical isolates than the combination of gentamicin with clindamycin, including gentamicin-resistant strains. ß

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“…In this respect, morphological evaluations of cemented femoral components are essential for the evaluation of the biological and mechanical responses to the prosthesis. 14,22 Several investigators have reported hypotheses regarding the factors that influence the failure of the cement-prosthesis interface. Possible causes of loosening at the bonecement interface have been related to thermal injury, cement shrinkage, monomer toxicity, creep, and inappropriate viscosity.…”

Section: Introductionmentioning

confidence: 99%

“…5 The shrinkage of cement could compromise the integrity of the cement-bone or cement-prosthesis interface. Wang et al 22 demonstrated that most cemented implants are associated with small gaps that are less than 100 μm and occupy about 10-15% of the surrounding bone-cement and cementstem interface. These gaps may reduce the bonding strength and initiate the debonding when loading the prostheses.…”

Section: A Introductionmentioning

confidence: 99%