Compression and Flexural Strength of Bone Cement Mixed with Blood

Tan, J. H.; Koh, Bryan T. H.; Ramruttun, AK; Wang, Wilson

doi:10.1177/1602400223

Cited by 22 publications

(17 citation statements)

References 31 publications

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“…Nevertheless, the exact mechanism of aseptic loosening of the prosthesis has not yet been sufficiently understood. It is believed, however, that its occurrence is the combined consequence of material fatigue and chemical degradation resulting from operation in an aggressive environment in vivo [17,18,19].…”

Section: Introductionmentioning

confidence: 99%

“…This scenario can be prevented; however, it is critical that the cement is prepared according to the standards. The cement preparation process has undergone gradual improvement with the introduction of vacuum mixing systems, cement application guns or cooling prior to mixing, which extends the polymerisation time [19,25].…”

Section: Introductionmentioning

confidence: 99%

“…Among contaminants that are frequently introduced into the cement structure during implantation, there are those that are to an extent dependent on the surgeon, such as residual blood or bone tissue. As a result, this may lead to the deterioration of the final mechanical strength properties, or the occurrence of delamination in the assembly [19,26].…”

Section: Introductionmentioning

confidence: 99%

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Seasoning Polymethyl Methacrylate (PMMA) Bone Cements with Incorrect Mix Ratio

2019

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Cemented joint prostheses are widely used in orthopaedic surgery; however, implants/bone bonds are known to be susceptible to aseptic loosening, particularly in the case of long-term performance. The exact mechanism of this failure is under constant examination. One of the critical factors to the final mechanical functionality of bone cement can be an incorrect mix ratio of a two-component material (powdered polymer and liquid monomer). It can result in the deterioration of the final mechanical strength properties. The paper presents the results from an experimental study on the effects of the deviation from the correct mix ratio on the moisture uptake and the compression strength of cement depending on the seasoning time in Ringer’s solution. The results were subjected to statistical analysis and a mathematical model was developed.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Seasoning Polymethyl Methacrylate (PMMA) Bone Cements with Incorrect Mix Ratio

2019

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“…Bone-cement contamination is a problem whose effects have not yet been thoroughly studied or presented in the specialist literature. In the study by Tan et al [34], it was shown that the rate of strength characteristics degradation of blood-contaminated cements was significantly greater when the composition of the cement contained gentamicin than with its absence. The results from their study are particularly interesting given that bone-cement compositions with antibiotics introduced by the manufacturer are widely used in Europe, whereas in the United States manual antibiotic powder addition to traditional bone cement during surgery is preferred [44].…”

Section: Discussionmentioning

confidence: 99%

“…Far too little attention has been paid to the effect of contamination on the cement strength properties, in particular in the presence of human blood [34]. The focus of bone-cement studies is on admixtures of auxiliary agents, supplied to improve the material’s properties, including strength [22,26,33,35,36,37,38].…”

Section: Introductionmentioning

confidence: 99%

Effect of Physiological Fluids Contamination on Selected Mechanical Properties of Acrylate Bone Cement

2019

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This study analyses the degradation rate of selected mechanical properties of bone cement contaminated with human blood and saline solution. During the polymerisation stage, the PMMA cement specimens were supplemented with the selected physiological fluids in a range of concentrations from 0% to 10%. The samples were then subjected to the standardised compression tests, as per ISO 5833: 2002, and hardness tests. The obtained results were analysed statistically to display the difference in the degradation of the material relative to the degree of contamination. Subsequently, numerical modelling was employed to determine the mathematical relationship between the degree of contamination and the material strength degradation rate. The introduction of various concentrations of contaminants into the cement mass resulted in a statistically significant change in their compressive strength. It was shown that the addition of more than 4% of saline and more than 6% of blood (by weight) causes that the specimens exhibit lower strength than the minimum critical value of 70 MPa, specified in the abovementioned International Standard. It was further revealed that the cement hardness characteristics degraded accordingly. The mathematical models showed a very good fit with the results from the experiments: The coefficient of determination R2 was 0.987 in the case of the linear hardness model for blood and 0.983 for salt solution; secondly, the values of R2 for the third-degree polynomial model of compressive strength were 0.88 for blood and 0.92 for salt. From the results, it can be seen that there is a quantitative/qualitative relationship between the contamination rate and the drop in the tested mechanical characteristics. Therefore, great effort must be taken to minimise the contact of the bone cement with physiological fluids, which naturally occur in the operative field, particularly when the material cures, in order to prevent the cement material strength declining below the minimum threshold specified in the ISO standard.

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PMMA Bone Cement Composite Functions as an Adjuvant Chemotherapeutic Platform for Localized and Multi‐Window Release during Bone Reconstruction

Cyphert

Kanagasegar

Zhang

et al. 2022

Macromolecular Bioscience

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Primary bone tumor resections often result in critical size defects, which then necessitate challenging clinical management approaches to reconstruct. One such intervention is the Masquelet technique, in which poly(methyl methacrylate) (PMMA) bone cement is placed as a spacer temporarily while adjuvant chemotherapeutics are administered systemically. The spacer is later removed and replaced with bone autograft. Local recurrence remains an important and devastating problem, therefore, a system capable of locally delivering chemotherapeutics will present unique advantages. In this work, a refillable chemotherapeutic (doxorubicin, DOX) delivery platform comprised of PMMA bone cement and insoluble 𝜸-cyclodextrin (𝜸-CD) polymeric microparticles is developed and explored towards application as a temporary adjuvant chemotherapeutic spacer. The system is characterized for porosity, mechanical strength, DOX filling and refilling capacity, elution kinetics, and cytotoxicity. Since residual chemotherapeutics can adversely impact bone healing, it is important that virtually all DOX be released from material. Composites containing 15 wt% 𝜸-CD microparticles demonstrate 100% DOX release within 100 days, whereas only 6% DOX is liberated from PMMA with free DOX over same period. Refillable properties of PMMA composite system may find utility for customizing dosing regimens. Findings suggest that PMMA composites can have potential as chemotherapeutic delivery platforms to assist in bone reconstruction.

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Compression and Flexural Strength of Bone Cement Mixed with Blood

Abstract: The biomechanical strength of PMMA contaminated with blood may decrease. Precautions such as saline lavage, pack drying the bone, change of gloves, and prompt insertion of the implant should be taken to prevent blood from contaminating bone cement.

Cited by 22 publications

References 31 publications

Seasoning Polymethyl Methacrylate (PMMA) Bone Cements with Incorrect Mix Ratio

Seasoning Polymethyl Methacrylate (PMMA) Bone Cements with Incorrect Mix Ratio

Effect of Physiological Fluids Contamination on Selected Mechanical Properties of Acrylate Bone Cement

PMMA Bone Cement Composite Functions as an Adjuvant Chemotherapeutic Platform for Localized and Multi‐Window Release during Bone Reconstruction

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