Penetration and Shear Strength of Cement???Bone Interfaces In Vivo

Macdonald, Warren; Swarts, Eric; Beaver, R.J.

doi:10.1097/00003086-199301000-00041

Cited by 96 publications

(66 citation statements)

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“…28,29 This study used a new standardized technique to augment hip screws in human proximal femurs, including pulsed lavage for fat and marrow removal prior to cement application-a technique taken from endoprosthetics. [30][31][32][33][34][35][36][37][38][39] To determine the benefit of this technique, it was compared to conventional fixation by means of a standard hip screw in a controlled experimental study, simulating the clinical postoperative situation as realistically as possible. Specimens were tested under loading conditions corresponding to the physiological situation 40 to investigate their biomechanical behavior in terms of implant anchorage.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of a new augmentation method for enhanced screw fixation in osteoporotic proximal femoral fractures

et al. 2006

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A biomechanical investigation on eight pairs of human cadaver proximal femurs was performed to evaluate the impact of a new augmentation method on the internal fixation of osteoporotic proximal femur fractures. The study focused on enhancing implant purchase to reduce the incidence of implant cut-out in osteoporotic bone. In a left-right comparison, a conventional hip screw fixation (control) was compared to the new cement augmentation method. After bone bed preparation through high pressure irrigation to remove fat, blood, and bone debris, the bones were augmented with low viscosity polymethylmethacrylate (PMMA) cement.Step-wise fatigue testing was performed by cyclically loading the femoral heads in a physiological manner, beginning at 1,500 N and increasing 500 N every 5,000 cycles to 4,000 N, and continuously monitoring head displacement. Failure was defined as >5.0 mm head displacement. The head displacement at 2,000 N was significantly smaller (p ¼ 0.018) for the augmented group as compared to the conventionally treated bones (0.09 AE 0.01 mm vs. 0.90 AE 0.32 mm; mean AE SEM). The displacement rate at the second load step was significantly higher (p ¼ 0.018) for the conventionally treated bones as compared to the augmented ones. All of the nonaugmented specimens failed during testing, where 50% of the augmented specimens did not fail. The promising results of these experiments suggest that this new standardized irrigation/augmentation method enhances the implant anchorage and offers a potential solution to the problem of implant cut-out in osteoporotic metaphyseal bone. ß

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Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of a new augmentation method for enhanced screw fixation in osteoporotic proximal femoral fractures

et al. 2006

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“…The exact mechanism for loosening is likely multifactorial with contributions from osteolysis and micromotion at the interface, bony changes due to stress adaptation and aging, and locally high fluid pressure. 9 A great deal is known about the strength of the cement-bone interface, [10][11][12][13][14] but surprisingly little is known about its micromechanical behavior (local deformations, stress levels, and motions due to loading). The term micromotion is often used to describe the small motions that can occur between implant, cement, and bone, but these descriptions are often indicative of global motion between different components of the reconstruction.…”

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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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“…The aspirator retractor, designed in 2000 and used in our series, reportedly improved cement penetration into trabecular bone in one study [17]. Cement penetration greater than 2 mm and an ideal penetration of 3 to 5 mm reportedly produces the strongest cement-bone interface [1,18,20]. However, we could not confirm an improvement in cement intrusion in this series.…”

Section: Discussionmentioning

confidence: 60%

The Influence of a Suction Device on Fixation of a Cemented Cup using RSA

Timperley

Whitehouse

Hourigan

2009

Clinical Orthopaedics &Amp; Related Research

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The quality of technique used at the time of socket cementation is crucial in ensuring a durable longterm result of the implant. We asked whether a new instrument, an aspirator retractor introduced into the wing of the ilium before socket preparation and cementation, would enhance cement fixation as defined by RSA and radiographic examination. We randomized 38 patients into two groups. The surgical technique was identical between the groups with the exception of the use of the aspirator retractor. Patients were followed clinically and with radiostereometry at a minimum of 2 years. We compared gross radiographic appearances, including the depth of penetration of cement and the incidence of postoperative and 2-year radiolucent lines. There was no difference in proximal migration between the two groups. No improvement of fixation was proven from the measured translations and rotations of the socket in the suction group. We found no difference in the number or extent of radiolucent lines or the depth of cement penetration when the iliac suction device was used in conjunction with contemporary cementing techniques. Although the data suggest no shortterm advantage in this small study, we will continue to follow these patients presuming there will be improved outcomes in the longer term and since the device provides an easier method of obtaining adequate fixation, especially if technical difficulties are encountered during the pressurization procedure.

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Penetration and Shear Strength of Cement???Bone Interfaces In Vivo

Cited by 96 publications

References 0 publications

Biomechanical evaluation of a new augmentation method for enhanced screw fixation in osteoporotic proximal femoral fractures

Biomechanical evaluation of a new augmentation method for enhanced screw fixation in osteoporotic proximal femoral fractures

Experimental micromechanics of the cement–bone interface

The Influence of a Suction Device on Fixation of a Cemented Cup using RSA

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