scholarly journals Fabrication of PLLA/C3S Composite Membrane for the Prevention of Bone Cement Leakage

Polymers ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 1971 ◽  
Author(s):  
Tsai-Hsueh Leu ◽  
Yang Wei ◽  
Yi-Shi Hwua ◽  
Xiao-Juan Huang ◽  
Jung-Tang Huang ◽  
...  

Kyphoplasty is an important treatment for stabilizing spine fractures due to osteoporosis. However, leakage of polymethyl-methacrylate (PMMA) bone cement during this procedure into the spinal canal has been reported to cause many adverse effects. In this study, we prepared an implantable membrane to serve as a barrier that avoids PMMA cement leakage during kyphoplasty procedures through a hybrid composite made of poly-l-lactic acid (PLLA) and tricalcium silicate (C3S), with the addition of C3S into PLLA matrix, showing enhanced mechanical and anti-degradation properties while keeping good cytocompatibility when compared to PLLA alone and most importantly, when this material design was applied under standardized PMMA cement injection conditions, no posterior wall leakage was observed after the kyphoplasty procedure in pig lumbar vertebral bone models. Testing results assess its effectiveness for clinical practice.

2020 ◽  
Vol 25 (2) ◽  
pp. 44-51
Author(s):  
Érica Miranda de Torres ◽  
José Valladares-Neto ◽  
Karina de Oliveira Bernades ◽  
Luis Fernando Naldi ◽  
Hianne Miranda de Torres ◽  
...  

ABSTRACT Objective: To evaluate facial profile changes promoted by polymethyl methacrylate (PMMA) cement graft to reduce excessive gingival display due to hyperactivity of the elevator muscles of the upper lip during smiling. Methods: Eleven patients (all females, age range: 20 to 43 years) presenting gingival smile that were treated with PMMA cement grafts in a private clinic were selected for this retrospective study. Three angular and ten linear cephalometric facial profile measurements were performed preoperatively (baseline, T1) and at least 6 months postoperatively (T2). Differences between T1 and T2 were verified by Wilcoxon test, and the correlation between the thickness of the graft and facial profile changes was statistically evaluated by Spearman’s Coefficient test. The significance level was set at p< 0.05. Results: The nasolabial angle (p= 0.03) and the labial component of the nasolabial angle showed statistically significant differences (p= 0.04), with higher values in T2. No correlations were found between the graft thickness and the statistically significant facial profile changes (p> 0.05). Conclusions: The PMMA bone cement graft projected the upper lip forward, thereby increasing the nasolabial angle without affecting the nasal component. No correlations between the graft thickness and the facial profile changes were detected.


2017 ◽  
Vol 14 (131) ◽  
pp. 20161057 ◽  
Author(s):  
Xu Cui ◽  
Chengcheng Huang ◽  
Meng Zhang ◽  
Changshun Ruan ◽  
Songlin Peng ◽  
...  

Although poly(methylmethacrylate) (PMMA) cements are widely used in orthopaedics, they have numerous drawbacks. This study aimed to improve their bioactivity and osseointegration by incorporating strontium-containing borate bioactive glass (SrBG) as the reinforcement phase and bioactive filler of PMMA cement. The prepared SrBG/PMMA composite cements showed significantly decreased polymerization temperature when compared with PMMA and retained properties of appropriate setting time and high mechanical strength. The bioactivity of SrBG/PMMA composite cements was confirmed in vitro , evidenced by ion release (Ca, P, B and Sr) from SrBG particles. The cellular responses of MC3T3-E1 cells in vitro demonstrated that SrBG incorporation could promote adhesion, migration, proliferation and collagen secretion of cells. Furthermore, our in vivo investigation revealed that SrBG/PMMA composite cements presented better osseointegration than PMMA bone cement. SrBG in the composite cement could stimulate new-bone formation around the interface between the composite cement and host bone at eight and 12 weeks post-implantation, whereas PMMA bone cement only stimulated development of an intervening connective tissue layer. Consequently, the SrBG/PMMA composite cement may be a better alternative to PMMA cement in clinical applications and has promising orthopaedic applications by minimal invasive surgery.


2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110663
Author(s):  
Kai Xu ◽  
Ya-Ling Li ◽  
Song-Hua Xiao

Objective This study was performed to compare the effectiveness and safety of vesselplasty versus vertebroplasty in the treatment of osteoporotic compression fractures with posterior wall rupture. Methods Patients who underwent treatment of a single osteoporotic vertebral compression fracture with posterior wall rupture from January 2016 to February 2020 were retrospectively reviewed. They were divided into a vesselplasty group (n = 17) and a vertebroplasty group (n = 43). Pain relief, radiographic outcomes, and bone cement leakage were compared between the two groups. Results There were no significant differences in the operation time, postoperative pain relief, vertebral compression recovery, or local Cobb angle improvement between the two groups. However, the overall bone cement leakage rate (29.4% vs. 67.4%) and spinal canal leakage rate (0.0% vs. 30.2%) were significantly lower in the vesselplasty group than vertebroplasty group. Conclusions Vesselplasty offers similar pain relief and vertebral compression recovery but lower spinal canal leakage compared with vertebroplasty. Vesselplasty is thus a better option than vertebroplasty for patients with osteoporotic compression fractures with posterior wall rupture.


Author(s):  
E J Harper

Poly (methylmethacrylate) (PMMA) bone cement, used to fix implants into the bone, produces good surgical results if used correctly. However, prostheses do eventually become loose and the breakdown of the cement mantle is a factor in this failure. Limitations of PMMA cement, which lead to problems with the fixation of the implant, include its mechanical characteristics and its influence upon surrounding bone, associated with the polymerization reaction. A bioactive bone cement is particularly designed to produce a better interface between the cement and bone. However, an improvement in mechanical properties, especially fatigue, creep and fracture toughness, are an added necessary requirement to increase the lifetime of a cemented implant. The development of a bioactive cement has been conducted mainly in two ways; firstly, to improve existing PMMA cement by the addition of various bioactive agents and secondly, to design an alternative matrix for the bioactive material to be combined with. The most promising investigations which have been conducted, along with their relative benefits and drawbacks, are discussed.


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Tiao Lin ◽  
Xun-Zi Cai ◽  
Ming-Min Shi ◽  
Zhi-Min Ying ◽  
Bin Hu ◽  
...  

Ultrasound (US) has been used to increase elution of antibiotic from an antibiotic-loaded poly(methyl methacrylate) (PMMA) bone cement (ALBC). We aimed to further investigate whether microbubbles-mediated US (US + MB) facilitate elution of vancomycin (VAN) from cylindrical specimens and enhance the activity of the eluted antibiotic againstStaphylococcus aureus(S. aureus) in vitro. The study groups comprised cylindrical bone cement fabricated with VAN (VAN), ALBC using US (VAN + US), and ALBC using MB-mediated US (VAN + US + MB). We also carried out an in vivo study involving the activity of VAN from cylindrical cement implanted in tibiae of New Zealand white rabbits inoculated withS. aureus. We found that (1) in vitro, elution from VAN + US + MB cylinders was significantly higher than from either the VAN or VAN + US specimens; (2) the activity of the eluted VAN from the VAN + US + MB cylinders against planktonicS. aureuswas significantly higher than from either the control or VAN or VAN + US specimens; and (3) in the rabbits, the activity of the eluted VAN from the VAN + US + MB cylinders againstS. aureuswas significantly higher than from either the control or VAN or VAN + US specimens. The present results suggest that VAN-loaded PMMA cement irradiated with MB-mediated US may have a role in controlling prosthetic joint infection.


2020 ◽  
pp. 1-9
Author(s):  
Zhikun Wang ◽  
Zaixue Li ◽  
Xiansen Zhang ◽  
Yingfeng Yu ◽  
Qingyu Feng ◽  
...  

BACKGROUND: Increasing reports on new cement formulations that address the shortcomings of PMMA bone cements and various active components have been introduced to improve the biological activity of PMMA cement. OBJECTIVE: Evaluating the biological properties of PMMA cements-reinforced with Bio-Gene allogeneic bone. METHODS: The MC3T3-E1 mouse osteoblast-like cells were utilized to determine the effects of Bio-Gene + PMMA on osteoblast viability, adhesion and differentiation. RESULTS: The combination of allogeneic bone and PMMA increased the number of adherent live cells compared to both control group and PMMA or Bio-Gene group. Scanning electron microscopy observed that the number of cells adhered to Bio-Gene + PMMA was larger than Bio-Gene and PMMA group. Compared with the control and PMMA or Bio-Gene group, the level of ALP and the number of calcium nodules after osteoinduction was remarkably enhanced in Bio-Gene + PMMA group. Additionally, the combination of Bio-Gene and PMMA induced the protein expression of osteocalcin, osterix and collagen I. CONCLUSION: The composition of PMMA and allogeneic bone could provide a more beneficial microenvironment for osteoblast proliferation, adhesion and differentiation. PMMA bone cement reinforced with Bio-Gene allogeneic bone may act as a novel bone substitute to improve the biological activity of PMMA cement.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kui Zhang ◽  
Jiang She ◽  
Yandong Zhu ◽  
Wenji Wang ◽  
Erliang Li ◽  
...  

Abstract Purpose To investigate risk factors of bone cement leakage in percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture (OVCF). Methods A total of 236 patients (344 vertebrae) who underwent PVP between November 2016 and June 2020 were enrolled in the study. Clinical and radiological characteristics, including age, gender, course of disease, trauma, type of vertebral fracture, cortical continuity of vertebral body, intervertebral vacuum cleft (IVC), fracture severity, fracture level, basivertebral foramen, bone cement dispersion types, the cement injection volume, the type of cement leakage, puncture approach, and intrusion of the posterior wall, were considered as potential risk factors. Three types of leakage (type-B, type-C, and type-S) were defined and risk factors for each type were analyzed. Logistic analysis was used to study the relationship between each factor and the type of cement leakage. Results The incidences of the three types of leakage were 28.5%, 24.4%, and 34.3%. The multinomial logistic analysis revealed that the factors of type-B leakage were the shape of cement and basivertebral foramen. One significant factor related to type-C leakage was cortical disruption, and the factors of type-S leakage were bone cement dispersion types, basivertebral foramen, cleft, fracture severity, an intrusion of the posterior wall, and gender. Conclusion Different types of cement leakage have their own risk factors, and the analysis of risk factors of these might be helpful in reducing the rate of cement leakage.


2019 ◽  
Vol 2 (4) ◽  
pp. 489
Author(s):  
Amin Zaza ◽  
Mohamed Habib ◽  
Nabil Fatahalla

Fracture in the adjacent levels is one of the consequences to the use of commercial poly methylmethacrylate (PMMA) bone cement. Modified PMMA with a reduced Young’s modulus was found to be safer for cancellous bone augmentation procedures. The aim of this research was to study the effect of adding hydroxyapatite (HA) nano-particles and acetone on different properties of PMMA cement. A commercial PMMA cement was used as a model for bone cement. Three groups of modified PMMA/nano-HA were investigated by adding 2, 4 and 6 wt. % of HA. Acetone as a porogen mixed with distilled water in different amounts (A/W: 1:1, 2:1.5 and 2:1g) was used to produce porous PMMA cement. The residual monomer, polymerization and mechanical properties under tension and compression tests were investigated. Young’s modulus detected from compression test decreased from 826.5±10 to 728±66 MPa by adding 6wt.% HA. Adding acetone to PMMA with 2:1.5g (A/W) has decreased the compressive Young’s modulus to 753±38 MPa. High Performance Liquid Chromatography (HPLC) measurements were carried out with intervals of 2 hours, 6 hours and 24 hours to evaluate the residual monomer for all groups. The amount of residual monomer has decreased after 24 hours of curing by adding acetone and nano-HA. Modifying PMMA by HA and acetone have inconsistent effect on the polymerization temperature. It was concluded that HA and acetone can be used to reduce the stiffness and residual monomer with enhanced biocompatibility of the commercial PMMA bone cement.


Author(s):  
Puneeth Shridhar ◽  
Yanfei Chen ◽  
Ramzi Khalil ◽  
Anton Plakseyhuk ◽  
Sung Kwon Cho ◽  
...  

Percutaneous vertebroplasty procedure is of major importance, given the significant increasing aging population and higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main features of PMMA bone cement on the heart, and the extent of influence of materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case report.


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