Long-term mechanical properties of a novel low-modulus bone cement for the treatment of osteoporotic vertebral compression fractures

Robo, Céline; Öhman‐Mägi, Caroline; Persson, Cecilia

doi:10.1016/j.jmbbm.2021.104437

Cited by 15 publications

(8 citation statements)

References 55 publications

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“…In the present study, a CS of 93 ± 7 MPa and 39 ± 1 MPa was obtained after 4 weeks, for V-steady and LA12, respectively. The same materials (LA12 and V-steady) and test conditions, previously gave a CS of 92 ± 17 MPa and 37 ± 1 MPa [ 23 , 24 ]. In contrast, there was a substantial difference between the E-modulus obtained in the current study as compared to previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, E-modulus of 3434 ± 282 MPa and 1202 ± 113 MPa were obtained after 4 weeks for V-steady and LA12, respectively. The same materials (LA12 and V-steady) and test conditions previously gave an E-modulus of 2070 ± 103 MPa and 948 ± 64 MPa [ 23 , 24 ]. The results of the current study are more in line with the material properties data given by the manufacturer of V-Steady [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…Monomer release and handling properties such as setting time, polymerization and glass transition temperature would all need verification. While a release of small amounts of LA would not be a concern, a previous study has showed a higher monomer release for LA12 than for V-Steady [ 24 ]. Previous studies have also reported on the handling properties for LA12 [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…These so called low-modulus PMMA cements have been developed for osteoporotic patients in particular [ 20 ]. One such material is a linoleic acid modified PMMA (LA-PMMA), where the additive of linoleic acid essentially works as a plasticizer [ 21 , 22 , 23 , 24 ]. For the low modulus PMMA developed for vertebroplasty, 12 vol% LA has mostly been used [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…One such material is a linoleic acid modified PMMA (LA-PMMA), where the additive of linoleic acid essentially works as a plasticizer [ 21 , 22 , 23 , 24 ]. For the low modulus PMMA developed for vertebroplasty, 12 vol% LA has mostly been used [ 23 , 24 ]. The LA-PMMA could have a potential also in discoplasty, for overcoming the mismatch in endplate–PMMA modulus and for reducing the risk for endplate fracture and subsidence.…”

Section: Introductionmentioning

confidence: 99%

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Low-Modulus PMMA Has the Potential to Reduce Stresses on Endplates after Cement Discoplasty

Lewin

Försth

Persson

2022

JFB

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Cement discoplasty has been developed to treat patients with advanced intervertebral disc degeneration. In discoplasty, poly(methylmethacrylate) (PMMA) bone cement is injected into the disc, leading to reduced pain and certain spinal alignment correction. Standard PMMA-cements have much higher elastic modulus than the surrounding vertebral bone, which may lead to a propensity for adjacent fractures. A PMMA-cement with lower modulus might be biomechanically beneficial. In this study, PMMA-cements with lower modulus were obtained using previously established methods. A commercial PMMA-cement (V-steady®, G21 srl) was used as control, and as base cement. The low-modulus PMMA-cements were modified by 12 vol% (LA12), 16 vol% (LA16) and 20 vol% (LA20) linoleic acid (LA). After storage in 37 °C PBS from 24 h up to 8 weeks, specimens were tested in compression to obtain the material properties. A lower E-modulus was obtained with increasing amount of LA. However, with storage time, the E-modulus increased. Standard and low-modulus PMMA discoplasty were compared in a previously developed and validated computational lumbar spine model. All discoplasty models showed the same trend, namely a substantial reduction in range of motion (ROM), compared to the healthy model. The V-steady model had the largest ROM-reduction (77%), and the LA20 model had the smallest (45%). The average stress at the endplate was higher for all discoplasty models than for the healthy model, but the stresses were reduced for cements with higher amounts of LA. The study indicates that low-modulus PMMA is promising for discoplasty from a mechanical viewpoint. However, validation experiments are needed, and the clinical setting needs to be further considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Low-Modulus PMMA Has the Potential to Reduce Stresses on Endplates after Cement Discoplasty

Lewin

Försth

Persson

2022

JFB

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Azo polymerization of citrate‐based biomaterial‐ceramic composites at physiological temperatures

Huddleston

Duan

2022

Nano Select

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Vertebral compression fractures due to osteoporosis are commonly treated with bone cements based on the non-degradable, mechanically stiff poly(methyl methacrylate) (PMMA), which relies on peroxide-initiated polymerization to quickly set the cement at the cost of high exothermic temperatures. Recently, there has been interest in developing degradable, bone mechanic-matching alternatives that pursue physiologically induced polymerization to both augment the handling of the material before application and to reduce high localized temperatures that may lead to tissue damage. Herein, we report the development and material characterization of a thermoresponsive, degradable bone cement that utilizes the azo-based radical initiator 2-2ʹ-azobis (4-methoxy-2,4-dimethyl valeronitrile) (V70) and a liquid citrate-based biomaterial-ceramic composite of methacrylated poly(1,8 octamethylene citrate) (mPOC) and hydroxyapatite (HA) nanoparticles (mPOC-HA) that has improved handling and tissue compatibility characteristics. Our results show that: (a) these composites remain liquid until they are exposed to body temperature, which initiates polymerization to form a solid, tough material with desirable, modular compressive strengths comparable to trabecular bone; (b) the addition of HA decreases temperature generation below the threshold that leads to tissue necrosis; and (c) composites remain biocompatible in vitro and in vivo.

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A survey on the mechanical properties of bone

Barekar,

Sarawade,

Kumar

2024

Multimed Tools Appl

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Long-term mechanical properties of a novel low-modulus bone cement for the treatment of osteoporotic vertebral compression fractures

Cited by 15 publications

References 55 publications

Low-Modulus PMMA Has the Potential to Reduce Stresses on Endplates after Cement Discoplasty

Low-Modulus PMMA Has the Potential to Reduce Stresses on Endplates after Cement Discoplasty

Azo polymerization of citrate‐based biomaterial‐ceramic composites at physiological temperatures

A survey on the mechanical properties of bone

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