scholarly journals Modified poly(methyl methacrylate) bone cement in the treatment of Kümmell disease

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Jinjin Zhu ◽  
Shuhui Yang ◽  
Yute Yang ◽  
Teng Yao ◽  
Gang Liu ◽  
...  
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Methyl Methacrylate ◽  
Bone Cement ◽  
Clinical Effects ◽  
Vertebral Height ◽  
Element Analysis ◽  
Poly Methyl Methacrylate ◽  
Pmma Bone Cement ◽  
Number Of Patients

Abstract Kümmell disease (KD) causes serious vertebral body collapse in patients. However, only a few case reports have been conducted and the number of patients with KD investigated was limited. Additionally, the frequently used poly(methyl methacrylate) (PMMA) bone cement for KD is limited by excessive modulus and poor biocompatibility. Herein, we aimed to modify PMMA bone cement with mineralized collagen (MC), and compare the clinical effects, image performance and finite element analysis between the modified bone cement and PMMA bone cement for the treatment of phase I and II KD. Thirty-nine KD patients treated with PMMA bone cement and 40 KD patients treated with MC-modified PMMA bone cement from June 2015 to March 2017 were retrospectively analyzed. The surgical procedure, intraoperative blood loss, hospital stay and complications were compared between different groups. Visual analog scale, Oswestry disability index, anterior vertebral height, posterior vertebral height, computed tomography value, adjacent vertebral re-fracture, Cobb angle and wedge-shaped correction angle were evaluated. Additionally, the representative sample was selected for finite element analysis. We found that the MC-modified PMMA bone cement could achieve the same effect as that of PMMA bone cement and was associated with better vertebral height restoration in the long term.

scholarly journals Poly(methyl methacrylate) bone cement composited with mineralized collagen for osteoporotic vertebral compression fractures in extremely old patients

2020 ◽  
Vol 7 (1) ◽  
pp. 29-34
Author(s):  
Kefeng Luo ◽  
Guoqiang Jiang ◽  
Jinjin Zhu ◽  
Bin Lu ◽  
Jiye Lu ◽  
...  
Keyword(s):  
Methyl Methacrylate ◽  
Bone Cement ◽  
Vertebral Compression Fractures ◽  
Pure Pmma ◽  
Osteoporotic Vertebral Compression Fractures ◽  
Vertebral Height ◽  
Poly Methyl Methacrylate ◽  
Compression Fractures ◽  
Pmma Bone Cement ◽  
Mineralized Collagen

Abstract To examine the clinical effects of a new bone cement composed of poly(methyl methacrylate) (PMMA) and mineralized collagen (MC) compared with pure PMMA bone cement in treating osteoporotic vertebral compression fractures (OVCFs) in patients aged over 80. In all, 32 cases using pure PMMA bone cement and 31 cases using MC-modified PMMA (MC-PMMA) bone cement for OVCFs between June 2014 and March 2016 were screened as PMMA group and MC-PMMA group, respectively, with an average age of over 80. The operation duration, intraoperative blood loss, hospital stay, oswestry disability index (ODI), visual analogue scale (VAS), anterior vertebral height (AVH), intermediate vertebral height (IVH) and posterior vertebral height (PVH) of injured vertebrae, vertebral computed tomography value, re-fracture rate of adjacent vertebrae, correction rate of spinal kyphotic angle and wedge-shaped vertebra angle and surgical complications were compared between the two groups. In the early post-operative period, the VAS, ODI, AVH and IVH in MC-PMMA group were comparable to those in the traditional PMMA group. Moreover, the MC-PMMA group showed better effects compared with the PMMA group 12 months after surgery. Thus, this new bone cement has superior clinic effects in the long term.

scholarly journals Influence of HRGO Nanoplatelets on Behaviour and Processing of PMMA Bone Cement for Surgery

Polymers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2027
Author(s):  
Jaime Orellana ◽  
Ynés Yohana Pastor ◽  
Fernando Calle ◽  
José Ygnacio Pastor
Keyword(s):  
Graphene Oxide ◽  
Methyl Methacrylate ◽  
Bone Cement ◽  
Reduced Graphene Oxide ◽  
Sintering Temperature ◽  
Structural Function ◽  
Mechanical And Thermal Properties ◽  
Poly Methyl Methacrylate ◽  
Pmma Bone Cement ◽  
Reduced Graphene

Bone cement, frequently based on poly (methyl methacrylate), is commonly used in different arthroplasty surgical procedures and its use is essential for prosthesis fixation. However, its manufacturing process reaches high temperatures (up to 120 °C), producing necrosis in the patients' surrounding tissues. To help avoid this problem, the addition of graphene could delay the polymerisation of the methyl methacrylate as it could, simultaneously, favour the optimisation of the composite material's properties. In this work, we address the effect of different percentages of highly reduced graphene oxide with different wt.% (0.10, 0.50, and 1.00) and surface densities (150, 300, 500, and 750 m2/g) on the physical, mechanical, and thermal properties of commercial poly (methyl methacrylate)-based bone cement and its processing. It was noted that a lower sintering temperature was achieved with this addition, making it less harmful to use in surgery and reducing its adverse effects. In contrast, the variation of the density of the materials did not introduce significant changes, which indicates that the addition of highly reduced graphene oxide would not significantly increase bone porosity. Lastly, the mechanical properties (strength, elastic modulus, and fracture toughness) were reduced by almost 20%. Nevertheless, their typical values are high enough that these new materials could still fulfil their structural function. In conclusion, this paper presents a way to control the sintering temperature, without significant degradation of the mechanical performance, by adding highly reduced graphene oxide so that local necrosis of bone cement based on poly (methyl methacrylate) used in surgery is avoided.

Axisymmetric Finite Element Analysis of a Debonded Total Hip Stem With an Unsupported Distal Tip

1996 ◽  
Vol 118 (3) ◽  
pp. 399-404 ◽  
Author(s):  
T. L Norman ◽  
V. C. Saligrama ◽  
K. T. Hustosky ◽  
T. A. Gruen ◽  
J. D. Blaha
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Stress Relaxation ◽  
Bone Cement ◽  
Cement Mantle ◽  
Load Level ◽  
Interface Conditions ◽  
Element Analysis ◽  
Cement Interface ◽  
Total Hip

A tapered femoral total hip stem with a debonded stem-cement interface and an unsupported distal tip subjected to constant axial load was evaluated using two-dimensional (2D) axisymmetric finite element analysis. The analysis was performed to test if the mechanical condition suggest that a “taper-lock” with a debonded viscoelastic bone cement might be an alternative approach to cement fixation of stem type cemented hip prosthesis. Effect of stem-cement interface conditions (bonded, debonded with and without friction) and viscoelastic response (creep and relaxation) of acrylic bone cement on cement mantle stresses and axial displacement of the stem was also investigated. Stem debonding with friction increased maximum cement von Mises stress by approximately 50 percent when compared to the bonded stem. Of the stress components in the cement mantle, radial stresses were compressive and hoop stresses were tensile and were indicative of mechanical taper-lock. Cement mantle stress, creep and stress relaxation and stem displacement increased with increasing load level and with decreasing stem-cement interface friction. Stress relaxation occur predominately in tensile hoop stress and decreased from 1 to 46 percent over the conditions considered. Stem displacement due to cement mantle creep ranged from 614 μm to 1.3 μm in 24 hours depending upon interface conditions and load level.

scholarly journals Effect of Augmentation Material Stiffness on Adjacent Vertebrae after Osteoporotic Vertebroplasty Using Finite Element Analysis with Different Loading Methods

2015 ◽  
Vol 6;18 (6;11) ◽  
pp. E1101-E1110
Author(s):  
Ah-Reum Cho
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Bone Cement ◽  
Vertebral Fractures ◽  
Three Dimensional ◽  
Element Model ◽  
Element Analysis ◽  
Adjacent Vertebral Body ◽  
Von Mises ◽  
Von Mises Stresses

Background: Vertebroplasty is an effective treatment for osteoporotic vertebral fractures, which are one of the most common fractures associated with osteoporosis. However, clinical observation has shown that the risk of adjacent vertebral body fractures may increase after vertebroplasty. The mechanism underlying adjacent vertebral body fracture after vertebroplasty is not clear; excessive stiffness resulting from polymethyl methacrylate has been suspected as an important mechanism. Objectives: The aim of our study was to compare the effects of bone cement stiffness on adjacent vertebrae after osteoporotic vertebroplasty under load-controlled versus displacementcontrolled conditions. Study Design: An experimental computer study using a finite element analysis. Setting: Medical research institute, university hospital, Korea. Methods: A three-dimensional digital anatomic model of L1/2 bone structure was reconstructed from human computed tomographic images. The reconstructed three-dimensional geometry was processed for finite element analysis such as meshing elements and applying material properties. Two boundary conditions, load-controlled and displacement-controlled methods, were applied to each of 5 deformation modes: compression, flexion, extension, lateral bending, and torsion. Results: The adjacent L1 vertebra, irrespective of augmentation, revealed nearly similar maximum von Mises stresses under the load-controlled condition. However, for the displacementcontrolled condition, the maximum von Mises stresses in the cortical bone and inferior endplate of the adjacent L1 vertebra increased significantly after cement augmentation. This increase was more significant than that with stiffer bone cement under all modes, except the torsion mode. Limitations: The finite element model was simplified, excluding muscular forces and incorporating a large volume of bone cement, to more clearly demonstrate effects of bone cement stiffness on adjacent vertebrae after vertebroplasty. Conclusion: Excessive stiffness of augmented bone cement increases the risk of adjacent vertebral fractures after vertebroplasty in an osteoporotic finite element model. This result was most prominently observed using the displacement-controlled method. Key words: Bone cements, displacement-controlled method, finite element analysis, loadcontrolled method, osteoporosis, osteoporotic fracture, polymethyl methacrylate, vertebroplasty

scholarly journals In Vitro Fatigue Failure of Cemented Acetabular Replacements: A Hip Simulator Study

2008 ◽  
Vol 130 (2) ◽  
Author(s):  
N. P. Zant ◽  
P. Heaton-Adegbile ◽  
J. G. Hussell ◽  
J. Tong
Keyword(s):  
Finite Element Analysis ◽  
Finite Element ◽  
Bone Cement ◽  
Cement Mantle ◽  
Stair Climbing ◽  
Normal Walking ◽  
Element Analysis ◽  
Cement Interface ◽  
Hip Simulator

Although hip simulators for in vitro wear testing of prosthetic materials used in total hip arthroplasty (THA) have been available for a number of years, similar equipment has yet to appear for endurance testing of fixation in cemented THA, despite considerable evidence of late aseptic loosening as one of the most significant failure mechanisms in this type of replacements. An in vitro study of fatigue behavior in cemented acetabular replacements has been carried out, utilizing a newly developed hip simulator. The machine was designed to simulate the direction and the magnitude of the hip contact force under typical physiological loading conditions, including normal walking and stair climbing, as reported by Bergmann et al. (2001, Hip 98, Freie Universitaet, Berlin). A 3D finite element analysis has been carried out to validate the function of the hip simulator and to evaluate the effects of boundary conditions and geometry of the specimen on the stress distribution in the cement mantle. Bovine pelvic bones were implanted with a Charnley cup, using standard manual cementing techniques. Experiments were carried out under normal walking and descending stairs loading conditions with selected load levels from a body weight of 75–125kg. Periodically, the samples were removed from the test rigs to allow CT scanning for the purpose of monitoring damage development in the cement fixation. The hip simulator was found to be satisfactory in reproducing the hip contact force during normal walking and stair climbing, as reported by Bergmann et al. Finite element analysis shows that the stress distributions in the cement mantle and at the bone-cement interface are largely unaffected by the geometry and the boundary conditions of the model. Three samples were tested up to 17×106cycles and sectioned post-testing for microscopic studies. Debonding at the bone-cement interface of various degrees in the posterior-superior quadrant was revealed in these samples, and the location of the failures corresponds to the highest stressed region from the finite-element analysis. Preliminary experimental results from a newly developed hip simulator seem to suggest that debonding at the bone-cement interface is the main failure mechanism in cemented acetabular replacements, and descending stairs seem to be more detrimental than normal walking or ascending stairs with regard to fatigue integrity of cement fixation.

scholarly journals Poly(methyl methacrylate) Bone Cement Composite Can Be Refilled with Antibiotics after Implantation in Femur or Soft Tissue

2021 ◽  
Vol 12 (1) ◽  
pp. 8
Author(s):  
Erika L. Cyphert ◽  
Ningjing Zhang ◽  
Dylan W. Marques ◽  
Greg D. Learn ◽  
Fang Zhang ◽  
...  
Keyword(s):  
Antimicrobial Activity ◽  
Soft Tissue ◽  
Methyl Methacrylate ◽  
Bone Cement ◽  
Muscle Tissue ◽  
Cement Composite ◽  
Poly Methyl Methacrylate ◽  
Intraosseous Infusion ◽  
Pmma Bone Cement ◽  
Antibiotic Release

While periprosthetic joint infections (PJIs) result in a small percentage of patients following arthroplasties, they are challenging to treat if they spread into bone and soft tissue. Treatment involves delivering antibiotics using poly(methyl methacrylate) (PMMA) bone cement. However, antibiotic release is insufficient for prolonged infections. Previous work demonstrated efficacy of incorporating insoluble cyclodextrin (CD) microparticles into PMMA to improve antibiotic release and allow for post-implantation drug refilling to occur in a tissue-mimicking model. To simulate how antibiotic refilling may be possible in more physiologically relevant models, this work investigated development of bone and muscle refilling models. The bone refilling model involved embedding PMMA-CD into rabbit femur and administering antibiotic via intraosseous infusion. Muscle tissue refilling model involved implanting PMMA-CD beads in bovine muscle tissue and administering antibiotic via tissue injection. Duration of antimicrobial activity of refilled PMMA-CD was evaluated. PMMA-CD composite in bone and muscle tissue models was capable of being refilled with antibiotics and resulted in prolonged antimicrobial activity. PMMA-CD provided sustained and on-demand antimicrobial activity without removal of implant if infection develops. Intraosseous infusion appeared to be a viable technique to enable refilling of PMMA-CD after implantation in bone, reporting for the first time the ability to refill PMMA in bone.

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