What Is Modern Cementing Technique?

Breusch, Steffen; Malchau, Henrik

doi:10.1007/3-540-28924-0_17

Cited by 13 publications

(7 citation statements)

References 39 publications

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“…2 For a good long time result, the main focus must be put on the fatigue properties of the cement and the cement-bone interface. 1,3 Therefore, many efforts have been made to improve bone cement by either enhancement of the mechanical properties of PMMA (i.e. fiber reinforcement, vacuum mixing) or improvement at the bone-cement interface through the development of bioactive bone cement.…”

Section: Introductionmentioning

confidence: 99%

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In vivo evaluation of bioactive PMMA-based bone cement with unchanged mechanical properties in a load-bearing model on rabbits

Fottner¹,

Nies

Kitanovic³

et al. 2015

J Biomater Appl

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Polymethylmethacrylate-based bone cements are widely used for fixation of joint replacements. To improve the long-term outcome, bioactive bone cements are aspired to advance the bone-cement interface. This study evaluated the in vivo properties of a new polymethylmethacrylate-based bioactive bone cement with addition of amphiphilic phosphorylated 2-hydroxyethylmethacrylate. Previous in vitro studies confirmed bioactive properties in cell culture, as well as unchanged mechanical properties are tests according to ISO 5833:2002.Three different variations of the cement (polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate, polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate + CaCl2 and polymethylmethacrylate + phosphorylated 2-hydroxyethylmethacrylate + CaCl2 + Na2CO3) were compared to conventional polymethylmethacrylate cement. To evaluate the properties under load-bearing conditions, a spacer prosthesis was implanted into the femoral diaphysis of 24 rabbits. Additionally, a cement plug was installed into the proximal tibia. After three months, polished sections with Giemsa surface staining were prepared. The bioactivity was determined using the bone affinity index.The sections showed a good osseointegration of the bioactive bone cement without cement cracks under load-bearing conditions. Regarding the bone affinity index, the bioactive bone cement revealed a significantly higher value in the proximal tibia (25.9-37.7%) and around the spacer prosthesis (36.8-58.9%) compared to the conventional polymethylmethacrylate cement (12.8-17.0%).The results confirm the in vivo bioactivity of this bone cement. The absence of cement cracks indicates a sufficient mechanical stability to fix prostheses with this bioactive cement, but for a final assessment long-term tests are necessary.

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Section: Introductionmentioning

confidence: 99%

“…Since PMMA does not adhere to bone, 3,4 a layer of intervening fibrous tissue is formed at the bone-cement interface. 5,6 Therefore, a sufficient penetration of the cement into cancellous bone is needed to provide adequate anchorage of the implant.…”

Section: Introductionmentioning

confidence: 99%

In vivo evaluation of bioactive PMMA-based bone cement with unchanged mechanical properties in a load-bearing model on rabbits

Fottner¹,

Nies

Kitanovic³

et al. 2015

J Biomater Appl

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“…Some studies have previously reported that polymethyl methacrylate (PMMA) bone cement, widely used for prosthesis fixation, does not bond directly with the bone. Instead, there is always an intervening fibrous tissue, possibly leading to subsequent aseptic loosening [ 2 , 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Titania-Containing Bone Cement Shows Excellent Osteoconductivity in A Synovial Fluid Environment and Bone-Bonding Strength in Osteoporosis

et al. 2021

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Titania bone cement (TBC) reportedly has excellent in vivo bioactivity, yet its osteoconductivity in synovial fluid environments and bone-bonding ability in osteoporosis have not previously been investigated. We aimed to compare the osteoconductivity of two types of cement in a synovial fluid environment and determine their bone-bonding ability in osteoporosis. We implanted TBC and commercial polymethylmethacrylate bone cement (PBC) into rabbit femoral condyles and exposed them to synovial fluid pressure. Rabbits were then euthanized at 6, 12, and 26 weeks, and affinity indices were measured to evaluate osteoconductivity. We generated a rabbit model of osteoporosis through bilateral ovariectomy (OVX) and an 8-week treatment with methylprednisolone sodium succinate (PSL). Pre-hardened TBC and PBC were implanted into the femoral diaphysis of the rabbits in the sham control and OVX + PSL groups. Affinity indices were significantly higher for TBC than for PBC at 12 weeks (40.9 ± 16.8% versus 24.5 ± 9.02%) and 26 weeks (40.2 ± 12.7% versus 21.2 ± 14.2%). The interfacial shear strength was significantly higher for TBC than for PBC at 6 weeks (3.69 ± 1.89 N/mm2 versus 1.71 ± 1.23 N/mm2) in the OVX + PSL group. These results indicate that TBC is a promising bioactive bone cement for prosthesis fixation in total knee arthroplasty, especially for osteoporosis patients.

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“…Improvements in cementing technique, which increase the strength and stability of the cement-bone interface by optimization of the cement-bone interlock, have produced improvements in the long-term success of the prosthesis. These include controlling the viscosity of cement at time of insertion [8,[10][11][12], cleaning the bone surface [12][13][14], the use of distal plugs in the femur [13], and pressurization of the cement [15]. In addition to cement interlock, the quality of cancellous bone (its geometry, presence of disease, and mechanical properties) affects the cement-bone interface strength [11].…”

Section: Introductionmentioning

confidence: 99%

The use of complementary non-destructive evaluation methods to evaluate the integrity of the cement—bone interface

Leung

New

Browne

2008

Proc Inst Mech Eng H

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The integrity of the cement-bone interface is vital to the long-term stability of cemented hip arthroplasty. Most of the previous studies investigating the interface have been confined to the continuum level, neglecting the effects of microstructure. Microscopic damage at the interface may eventually lead to macroscopic loosening of the implant. However, as the strength of the interface depends on the interlock of the cement with bone and because the properties of cancellous bone depend on its microstructure, the study of the behaviour of the interface at the microstructural level may help to gain an understanding of the factors governing initiation of loosening. In this study, two complementary non-destructive methods, acoustic emission (AE) and computed tomography (CT), have been implemented to study the initiation and progression of damage of an analogue cement-bone interface sample under four-point bending. Early failure was detected, localized, and characterized using AE. CT images of the sample before and after loading were used to visualize damage in three dimensions. Damage initiated at the interface and was found to be related to stress-raising microstructural features in the cement. These were caused by irregularities in the geometry of the bone analogue and recesses and notches formed by the flow of cement.

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What Is Modern Cementing Technique?

Cited by 13 publications

References 39 publications

In vivo evaluation of bioactive PMMA-based bone cement with unchanged mechanical properties in a load-bearing model on rabbits

In vivo evaluation of bioactive PMMA-based bone cement with unchanged mechanical properties in a load-bearing model on rabbits

Titania-Containing Bone Cement Shows Excellent Osteoconductivity in A Synovial Fluid Environment and Bone-Bonding Strength in Osteoporosis

The use of complementary non-destructive evaluation methods to evaluate the integrity of the cement—bone interface

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