Vital staining of bone in stable, retrieved femoral surface replacement prostheses: A microscopic study of undecalcified ground sections

Morberg, Per; Johansson, Carina B.; Reigstad, Astor; Røkkum, Magne

doi:10.1054/arth.2001.27255

Cited by 8 publications

(3 citation statements)

References 24 publications

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“…In well-vascularized areas, necrotic bone may remodel into healthy bone, 4 resulting in direct bone-cement contact, though this bone may not be fully mineralized. [5][6][7] Under ideal conditions, the cement-bone interface may remain intact for years without an adverse biological response. 8 However, conditions are often compromised, leading to progressive interface failure accompanied by clinical radiolucencies, component migration, and pain.…”

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confidence: 99%

Experimental micromechanics of the cement–bone interface

Mann

Miller

Cleary

et al. 2008

Journal Orthopaedic Research

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Despite the widespread use of cement as a means of fixation of implants to bone, surprisingly little is known about the micromechanical behavior in terms of the local interfacial motion. In this work, we utilized digital image correlation techniques to quantify the micromechanics of the cement-bone interface of laboratory-prepared cemented total hip replacements subjected to nondestructive, quasistatic tensile and compressive loading. Upon loading, the majority of the displacement response localized at the contact interface region between cement and bone. The contact interface was more compliant ( p ¼ 0.0001) in tension (0.0067 AE 0.0039 mm/MPa) than compression (0.0051 AE 0.0031 mm/MPa), and substantial hysteresis occurred due to sliding contact between cement and bone. The tensile strength of the cement-bone interface was inversely proportional to the compliance of the interface and proportional to the cement/bone contact area. When loaded beyond the ultimate strength, the strain localization process continued at the contact interface between cement and bone with microcracking (damage) to both. More overall damage occurred to the cement than to the bone. The opening and closing at the contact interface from loading could serve as a conduit for submicron size particles. In addition, the cement mantle is not mechanically supported by surrounding bone as optimally as is commonly assumed. Both effects may influence the longevity of the reconstruction and could be considered in preclinical tests. ß

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confidence: 99%

Experimental micromechanics of the cement–bone interface

Mann

Miller

Cleary

et al. 2008

Journal Orthopaedic Research

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“…Necrosis has been found in bone adjacent to cement in human vertebroplasty retrievals and in a rabbit vertebroplasty model . Retrieval of cemented hip resurfacing constructs have documented 55% empty lacunae in interdigitated regions, suggesting that some of the interdigitated bone may not be viable. In addition, staining via tetracycline label given to patients 5 days prior to revision was not present in the interdigitated regions.…”

Section: Discussionmentioning

confidence: 99%

Early Changes in Cement–Bone Fixation Using a Novel Rat Knee Replacement Model

Mann

Miller

Amendola

et al. 2019

Journal Orthopaedic Research

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Trabecular resorption from interdigitated regions between cement and bone has been found in postmortem‐retrieved knee replacements, but the viability of interdigitated bone, and the mechanism responsible for this bone loss is not known. In this work, a Sprague–Dawley (age 12 weeks) rat knee replacement model with an interdigitated cement–bone interface was developed. Morphological and cellular changes in the interdigitated region of the knee replacement over time (0, 2, 6, or 12 weeks) were determined for ovariectomy (OVX) and Sham OVX treatment groups. Interdigitated bone volume fraction (BV/TV) increased with time for Sham OVX (0.022 BV/TV/wk) and OVX (0.015 BV/TV/wk) group, but the rate of increase was greater for the Sham OVX group (p = 0.0064). Tissue mineral density followed a similar increase with time in the interdigitated regions. Trabecular resorption, when it did occur, started at the cement border with medullary‐adjacent bone in the presence of osteoclasts. There was substantial loss of viable bone (~80% empty osteocyte lacunae) in the interdigitated regions. Pre‐surgical fluorochrome labels remained in the interdigitated regions, and did not diminish with time, indicating that the bone was not remodeling. There was also some evidence of continued surface mineralization in the interdigitated region after cementing of the knee, but this diminished over time. Statement of clinical significance: Interdigitated bone with cement provides mechanical stability for success of knee replacements. Improved understanding of the fate of the interdigitated bone over time could lead to a better understanding of the loosening process and interventions to prevent loss of fixation. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2163–2171, 2019

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“…Histopathology of the bone‐to‐cement interface is considered of utmost importance (Draenert et al, ). In spite of the need, there is still relatively few illustrated histology presenting the bone cement together with the adjacent tissue or even together with the prosthesis (Lye et al, ; Morberg et al, ).…”

Section: Discussionmentioning

confidence: 99%