Modification of PMMA vertebroplasty cement for reduced stiffness by addition of normal saline: a material properties evaluation

Schröder, Christian; Nguyen, Mai Lan; Kraxenberger, Michael; Yan, Cheng; Melcher, Carolin; Wegener, Bernd; Birkenmaier, Christof

doi:10.1007/s00586-016-4845-1

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…The t set is an essential clinical requirement in applications such as vertebroplasty and kyphoplasty, where the cement is injected through the vertebra. On the other hand, prolonged t set facilitates the manageability of the ABC during the procedure [ 49 , 50 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

Acrylic Bone Cements Modified with Graphene Oxide: Mechanical, Physical, and Antibacterial Properties

et al. 2020

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Bacterial infections are a common complication after total joint replacements (TJRs), the treatment of which is usually based on the application of antibiotic-loaded cements; however, owing to the increase in antibiotic-resistant microorganisms, the possibility of studying new antibacterial agents in acrylic bone cements (ABCs) is open. In this study, the antibacterial effect of formulations of ABCs loaded with graphene oxide (GO) between 0 and 0.5 wt.% was evaluated against Gram-positive bacteria: Bacillus cereus and Staphylococcus aureus, and Gram-negative ones: Salmonella enterica and Escherichia coli. It was found that the effect of GO was dependent on the concentration and type of bacteria: GO loadings ≥0.2 wt.% presented total inhibition of Gram-negative bacteria, while GO loadings ≥0.3 wt.% was necessary to achieve the same effect with Gram-positives bacteria. Additionally, the evaluation of some physical and mechanical properties showed that the presence of GO in cement formulations increased wettability by 17%, reduced maximum temperature during polymerization by 19%, increased setting time by 40%, and increased compressive and flexural mechanical properties by up to 17%, all of which are desirable behaviors in ABCs. The formulation of ABC loading with 0.3 wt.% GO showed great potential for use as a bone cement with antibacterial properties.

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Section: Resultsmentioning

confidence: 99%

Acrylic Bone Cements Modified with Graphene Oxide: Mechanical, Physical, and Antibacterial Properties

et al. 2020

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“…Excessive mechanical strength may increase the risk of adjacent vertebral fracture after PVP and PKP 37-39. Therefore, many researchers tried to add various media, such as hyaluronic acid 40, linoleic acid 41, saline solution 28 and even patients' blood 42, to decrease the mechanical strength to make PMMA bone cements more suitable for cancellous bone, especially osteoporotic bone. In summary, as long as the mechanical strength meets the ISO5833:2002(E) guideline, appropriate strength reduction is a safe procedure and is even preferred for clinical applications.…”

Section: Resultsmentioning

confidence: 99%

“…However, for bone tumor clinical applications, PMMA bone cement can be used only for mechanical support implantation and cannot kill tumor cells or prevent tumor progression. In additional, PMMA is of limited use in patients suffering from osteoporosis owing to its excessively strong stiffness 28. Moreover, the short window for operation and polymerization heat restrict the utilization and promotion of PMMA in clinical bone tumor treatment 29.…”

Section: Introductionmentioning

confidence: 99%

PMMA-Fe₃O₄ for internal mechanical support and magnetic thermal ablation of bone tumors

Liang

Zheng

et al. 2019

Theranostics

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Background : Minimally invasive modalities are of great interest in the field of treating bone tumors. However, providing reliable mechanical support and fast killing of tumor cells to achieve rapid recovery of physical function is still challenging in clinical works. Methods : A material with two functions, mechanical support and magnetic thermal ablation, was developed from Fe 3 O 4 nanoparticles (NPs) distributed in a polymethylmethacrylate (PMMA) bone cement. The mechanical properties and efficiency of magnetic field-induced thermal ablation were systematically and successfully evaluated in vitro and ex vivo . CT images and pathological examination were successfully applied to evaluate therapeutic efficacy with a rabbit bone tumor model. Biosafety evaluation was performed with a rabbit in vivo , and a cytotoxicity test was performed in vitro . Results : An NP content of 6% Fe 3 O 4 (PMMA-6% Fe 3 O 4 , m Fe : 0.01 g) gave the most suitable performance for in vivo study. At the 56-day follow-up after treatment, bone tumors were ablated without obvious side effects. The pathological examination and new bone formation in CT images clearly illustrate that the bone tumors were completely eliminated. Correspondingly, after treatment, the tendency of bone tumors toward metastasis significantly decreased. Moreover, with well-designed mechanical properties, PMMA-6%Fe 3 O 4 implantation endowed tumor-bearing rabbit legs with excellent bio-mimic bone structure and internal support. Biosafety evaluation did not induce an increase or decrease in the immune response, and major functional parameters were all at normal levels. Conclusion : We have presented a novel, highly efficient and minimally invasive approach for complete bone tumor regression and bone defect repair by magnetic thermal ablation based on PMMA containing Fe 3 O 4 NPs; this approach shows excellent heating ability for rabbit VX2 tibial plateau tumor ablation upon exposure to an alternating magnetic field (AMF) and provides mechanical support for bone repair. The new and powerful dual-function implant is a promising minimally invasive agent for the treatment of bone tumors and has good clinical translation potential.

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“…Analyses related to the presence of saline in the cement composition are also known. The admixture of this material was studied, among others, to a large extent at 10-30% [51]. Although saline often occurs in surgical practice in the bone cavity during surgery, this amount cannot be treated as resulting from accidental contamination.…”

Section: Discussionmentioning

confidence: 99%

Effect of Physiological Saline Solution Contamination on Selected Mechanical Properties of Seasoned Acrylic Bone Cements of Medium and High Viscosity

et al. 2020

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Bone cements play a key role in present-day surgery, including the implantation of hip and knee joint endoprostheses. The correct and durable bonding of the prosthesis to the bone is affected by both the static strength characteristics determined in accordance with ISO 5833:2002 and the resistance to long-term exposure to an aggressive environment of the human body and the impurities that may be introduced into the cement during implementation. The study attempts to demonstrate statistically significant degradation of cement as a result of the seasoning of cement samples in Ringer’s solution with simultaneous contamination of the material with saline solution, which is usually present in the surgical field (e.g., during the fixing of endoprostheses). The results of statistical analysis showed the nature of changes in compressive strength and microhardness due to seasoning time and degree of contamination.

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Modification of PMMA vertebroplasty cement for reduced stiffness by addition of normal saline: a material properties evaluation

Cited by 16 publications

References 25 publications

Acrylic Bone Cements Modified with Graphene Oxide: Mechanical, Physical, and Antibacterial Properties

Acrylic Bone Cements Modified with Graphene Oxide: Mechanical, Physical, and Antibacterial Properties

PMMA-Fe₃O₄ for internal mechanical support and magnetic thermal ablation of bone tumors

Effect of Physiological Saline Solution Contamination on Selected Mechanical Properties of Seasoned Acrylic Bone Cements of Medium and High Viscosity

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Modification of PMMA vertebroplasty cement for reduced stiffness by addition of normal saline: a material properties evaluation

Cited by 16 publications

References 25 publications

Acrylic Bone Cements Modified with Graphene Oxide: Mechanical, Physical, and Antibacterial Properties

Acrylic Bone Cements Modified with Graphene Oxide: Mechanical, Physical, and Antibacterial Properties

PMMA-Fe3O4 for internal mechanical support and magnetic thermal ablation of bone tumors

Effect of Physiological Saline Solution Contamination on Selected Mechanical Properties of Seasoned Acrylic Bone Cements of Medium and High Viscosity

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Product

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PMMA-Fe₃O₄ for internal mechanical support and magnetic thermal ablation of bone tumors