Dataset Information

A Geometric Analysis of Polyethylene Liners Exposed to Acrylic-based Bone Cement.

ABSTRACT:

Background

Acrylic-based bone cement (polymethyl methacrylate [PMMA]) is a material commonly used in orthopaedic surgeries; however, during PMMA polymerization, a highly exothermic reaction occurs. The heat released in polymerization can damage nearby materials including poorly heat-resistant cross-linked polyethylene (XLPE). Both PMMA and XLPE are used in total hip arthroplasty and could interact during femoral stem fixation. We sought to determine if the exothermic polymerization of PMMA could alter the surface characteristics of XLPE acetabular liners.

Methods

Six XLPE liners were assigned to one of 4 experimental categories with varying volumes of PMMA applied in a manner that mimicked how the 2 materials would come into contact intraoperatively. Measurements were taken both pre- and post-intervention using a coordinate measuring machine for geometric and gravimetric analysis. Light microscopy was conducted postintervention to examine the surface for damage.

Results

Coordinate measuring machine measurements showed minimal gross deformation in all 6 liners, but there were isolated surface deposits in 4 of 6 liners. The average maximal surface deviations, when compared to the control, for liners exposed to 1 cc of cement, 2 cc of cement, or 1 cc of cement with a femoral head implant attached were 26.6 μm, 77.2 μm, and 26.4 μm, respectively. All but one liner showed an increase in volume following intervention when compared to the control. Subtle scratches were identified using light microscopy on all 6 liners.

Conclusions

XLPE shows areas of isolated surface deformation in a dose-dependent manner but with minimal gross deformation after interacting with highly exothermic PMMA.

SUBMITTER: Thompson Z

PROVIDER: S-EPMC10517260 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

A Geometric Analysis of Polyethylene Liners Exposed to Acrylic-based Bone Cement.

Thompson Zoe Z Hothi Harry H Brillantes Jacqueline J Khoshbin Amir A Atrey Amit A

Arthroplasty today 20230919

<h4>Background</h4>Acrylic-based bone cement (polymethyl methacrylate [PMMA]) is a material commonly used in orthopaedic surgeries; however, during PMMA polymerization, a highly exothermic reaction occurs. The heat released in polymerization can damage nearby materials including poorly heat-resistant cross-linked polyethylene (XLPE). Both PMMA and XLPE are used in total hip arthroplasty and could interact during femoral stem fixation. We sought to determine if the exothermic polymerization of PM ...[more]

PMID: 37745962

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Project description:ObjectiveThis work focuses on tackling the inadequate bone/implant interface strength of acrylic bone cements, which is a formidable problem diminishing their clinical performance, especially in percutaneous kyphoplasty surgery.MethodsA new strategy of incorporating magnesium particles into clinically used poly(methylmethacrylate) (PMMA) bone cement to prepare a surface-degradable bone cement (SdBC) is proposed and validated both in vitro and in vivo.ResultsThis surface degradation characteristic enables osseointegrative, angiogenic and antiinfective properties. SdBC showed fast surface degradation and formed porous surfaces as designed, while the desirable high compressive strengths (≥70 MPa) of the cement were preserved. Besides, the SdBC with proper Mg content promoted osteoblast adhesion, spreading, proliferation and endothelial cell angiogenesis capacity compared with PMMA. Also, SdBC demonstrated clear inhibitory effect on Staphylococcus aureus and Escherichia coli. In vivo evaluation on SdBC by the rat femur defect model showed that the bone/implant interface strength was significantly enhanced in SdBC (push-out force of 11.8 ± 1.5 N for SdBC vs 7.0 ± 2.3N for PMMA), suggesting significantly improved osseointegration and bone growth induced by the surface degradation of the cement. The injectability, setting times and compressive strengths of SdBC with proper content of Mg particles (2.8 wt% and 5.4 wt%) were comparable with those of the clinical acrylic bone cement, while the heat release during polymerization was reduced (maximum temperature 78 ± 1 °C for PMMA vs 73.3 ± 1.5 °C for SdBC).ConclusionsThis work validates a new concept of designing bioactive bone/implant interface in PMMA bone cement. And this surface-degradable bone cement possesses great potential for minimally invasive orthopaedic surgeries such as percutaneous kyphoplasty.The translational potential of this articleThis work reports PMMA/Mg surface-degradable acrylic bone cements that possess enhanced osseointegrative, angiogenic and antiinfective properties that are lacking in the clinically used acrylic bone cements. This new kind of bone cements could improve the treatment outcome of many orthopaedic surgeries such as percutaneous kyphoplasty and arthroplasty.

Project description:BackgroundVitamin E-diffused highly cross-linked polyethylene (HXLPE/Vit E) is a relatively advanced material used in total hip arthroplasty (THA) but whether it shows superiority is unclear.ObjectiveThis meta-analysis was performed to investigate the effect of HXLPE/Vit E liners in THA.MethodsMedline/PubMed, Embase and Cochrane Library databases were searched to retrieve studies assessing the efficacy of HXLPE/Vit E liners in THA with the design of a randomized, controlled trial. Meta-analyses were conducted to merge the outcome estimates of interest, such as the femoral head penetration (FHP), FHP rate, FHP in x- (medial/lateral), y- (vertical) and z- (anteroposterior) axes, cup inclination angle, Harris hip score (HHS), numeric rating scale (NRS) and complications. Then pooled outcomes at different time points during the follow-up period were calculated.ResultsFollow an elaborate search of related databases, 23 studies involving a total of 54,920 participants were deemed eligible for this meta-analysis. The pooled results revealed significant decreased FHP at the last follow-up (pooled Mean Difference [MD] = -0.10, 95% confidence intervals [CIs]: -0.14 to -0.06). The subgroup analysis revealed a consistent trend at different time points during the follow-up. Significant decrease in the FHP rate were identified at the postoperative 1-2 years (pooled MD = -0.01, 95% CIs: -0.02 to -0.00) rather than at 2-5, 5-7, and 7-10 years. The combined results of clinical scores demonstrated no significant changes in the HHS, NRS, and EQ-5D variables. Additionally, no significant differences in the revision and cup inclination angle were identified during the follow-up period.ConclusionsThis study indicated that HXLPE/Vit E liner in total hip arthroplasty may decrease the femoral head penetration, mainly due to the decreased wear in proximal directions. However, no improvement on the clinical functions and complications were identified, and whether HXLPE/Vit E has the potential to prevent implant loosening or revision surgery could not be identified, which requires to be elaborated by high-quality randomized controlled trials.

Dataset Information

A Geometric Analysis of Polyethylene Liners Exposed to Acrylic-based Bone Cement.

Background

Methods

Results

Conclusions

Publications

A Geometric Analysis of Polyethylene Liners Exposed to Acrylic-based Bone Cement.

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