PostprintThis is the accepted version of a paper published in Journal of The Mechanical Behavior of Biomedical Materials. This paper has been peer-reviewed but does not include the final publisher proofcorrections or journal pagination.
Citation for the original published paper (version of record):López, A., Mestres, G., Karlsson Ott, M., Engqvist, H., Ferguson, S. et al. (2014) Compressive mechanical properties and cytocompatibility of bone-compliant, linoleic acidmodified bone cement in a bovine model.
Journal of The Mechanical
AbstractAdjacent vertebral fractures are a common complication experienced by osteoporosis patients shortly after vertebroplasty. Whether these fractures are due to the bone cement properties, the cement filling characteristics or to the natural course of the disease is still unclear. However, some data suggests that such fractures might occur because of an imbalance in the load distribution due to a mismatch between the elastic modulus (E) of the bonecement composite, and that of the vertebral cancellous bone. In this study, the properties of bone-compliant linoleic acid-modified bone cements were assessed using a bovine vertebroplasty model. Two groups of specimens (cementonly and bone-cement composites), and four subgroups comprising bone cements with elastic moduli in the range of 870-3500 MPa were tested to failure in uniaxial compression. In addition, monomer release as well as time and concentration-dependent cytocompatibility was assessed through the cement extracts using a Saos-2 cell model.Composites augmented with bone-compliant cements exhibited a reduction in E despite of their relatively high bone volume fraction (BVF). Moreover, a significant positive correlation between the BVF and E for the composites augmented with 870 MPa modulus cements was found. This was attributed to the increased relative contribution of the bone to the mechanical properties of the composites with a decrease in E of the bone cement. The use of linoleic acid reduced monomer conversion resulting in six times more monomer released after 24 hours. However, the cytocompatibility of the bone-compliant cements was comparable to that of the unmodified cements after the extracts were diluted four times. This study represents an important step towards introducing viable bone-compliant bone cements into vertebroplasty practice.