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Anaesthesia Feb 1989
Topics: Animals; Bone Cements; Bronchial Spasm; Chick Embryo; Female; Hip Prosthesis; Humans; Intraoperative Complications; Methylmethacrylate; Methylmethacrylates
PubMed: 2929964
DOI: 10.1111/j.1365-2044.1989.tb11215.x -
BioMed Research International 2015Mechanical alignment deviation after total knee arthroplasty is a major reason for early loosening of the prosthesis. Achieving optimum cement penetration during...
INTRODUCTION
Mechanical alignment deviation after total knee arthroplasty is a major reason for early loosening of the prosthesis. Achieving optimum cement penetration during fixation of the femoral and tibial component is an essential step in performing a successful total knee arthroplasty. Bone cement is used to solidify the bone and prosthesis. Thickness imbalance of bone cement leads to the deviation of mechanical alignment. To estimate the influence of bone cement, a retrospective study was conducted.
MATERIALS AND METHODS
A total of 36 subjects were studied. All the TKA were performed following the standard surgical protocol for navigated surgery by medial approach with general anaesthesia. Prostheses were fixed by bone cement.
RESULTS
We compared the mechanical axis, flexion/extension, and gap balance before and after cementation. All the factors were different compared with those before and after cementation. Internal rotation was reached with statistical significance (P=0.03).
CONCLUSION
Bone cement can influence the mechanical axis, flexion/extension, and gap balance. It also can prompt us to make a change when poor knee kinematics were detected before cementation.
Topics: Aged; Arthroplasty, Replacement, Knee; Bone Cements; Female; Humans; Knee Prosthesis; Male; Middle Aged; Prosthesis Failure; Range of Motion, Articular; Retrospective Studies
PubMed: 25688349
DOI: 10.1155/2015/109402 -
BMC Neurology Nov 2020To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases.
BACKGROUND
To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases.
METHODS
The medical records of patients with spinal metastatic tumor admitted to our hospital from January 2016 to December 2018 were retrospectively analyzed. Based on different surgical methods, the patients were divided into groups A (treated with RFA combined with bone cement) and B (treated with bone cement only). Group A included 35 patients with 47 segments of diseased vertebral bodies. Group B consisted of 52 patients with 78 vertebral segments. Pain, quality of life score, vertebra height, bone cement leakage, postoperative tumor recurrence, and complications were assessed 3 days and 1 and 6 months after surgery.
RESULTS
All the patients had smooth operation without paraplegia, spinal cord injury, and perioperative death. Visual analogue scales (VAS) and Oswestry Disability Index (ODI) scores of the two groups significantly improved 3 days and 1 month after surgery compared with those before surgery (P < 0.05), but no significant difference was observed between the two groups (P > 0.05). Six months after surgery, the VAS and ODI scores of patients in group A were lower than those in group B, with statistically significant differences (P < 0.05). The postoperative vertebral body height of the two groups significantly increased compared with that before surgery, and the difference was statistically significant (P < 0.05). Meanwhile, no significant difference was observed between the two groups (P > 0.05). Postoperative bone cement permeability in group A was 6.4%, and postoperative tumor recurrence rate was 11.4%. The permeability of bone cement in group B was 20.5%, and the tumor recurrence rate was 30.8%. The bone cement permeability and tumor recurrence rate in group A were lower than those in group B, with statistically significant differences (P < 0.05).
CONCLUSIONS
Bone cement combined with RFA for the treatment of spinal metastases can achieve good efficacy, desirable analgesic effect, low incidence of complications, small surgical trauma, and high safety. The proposed method has the value of clinical popularization and application.
Topics: Bone Cements; Female; Humans; Male; Middle Aged; Quality of Life; Radiofrequency Ablation; Retrospective Studies; Spinal Fractures; Spinal Neoplasms; Treatment Outcome
PubMed: 33208129
DOI: 10.1186/s12883-020-01998-5 -
Orthopaedics & Traumatology, Surgery &... Dec 2022Little is known about the impact irrigation solutions have on the material properties of cement used in hip and knee arthroplasty. We sought to compare the effect of...
INTRODUCTION
Little is known about the impact irrigation solutions have on the material properties of cement used in hip and knee arthroplasty. We sought to compare the effect of three commonly used lavage solutions on cement polymerization.
METHODS
Ten groups were used for cure and mechanical testing: two cement controls, and eight cement groups mixed with test solutions. Test solutions included a commercially available benzalkonium chloride/citric acid solution (BCS), chlorhexidine gluconate (0.05%) (CHG), povidone-iodine 0.35%, and normal saline added at cement mixing onset. Cement dough-time, set-time, and compression testing were performed following The American Society for Testing and Materials guidelines.
RESULTS
Povidone-iodine had shorter dough-time (1min 34sec, sd 1min 5sec) versus controls (1min 56sec, sd 1min 35sec), p=0.0419. Cement exposed to all lavage samples had significantly reduced set-time. Compressive strength was reduced for all surgical lavages (p<0.001). Pairwise testing revealed that all lavage treatments reduced offset strength versus controls (p<0.001).
CONCLUSION
Bone cement exposed to lavage solutions during the cement mixing-phase showed accelerated set-times and decreased compressive strength. If bone is not dry, and cement has not finished mixing at the time of application, cement curing time may be shortened. Additionally, bone cement should reach dough phase prior to pre-closure surgical lavage.
LEVEL OF EVIDENCE
III; case control study.
Topics: Humans; Bone Cements; Therapeutic Irrigation; Povidone-Iodine; Polymerization; Case-Control Studies
PubMed: 35158106
DOI: 10.1016/j.otsr.2022.103243 -
Acta Orthopaedica Et Traumatologica... Jul 2020The aim of this study was to show whether local application of cadmium-impregnated bone cement can induce apoptosis and decrease the viability of residual osteosarcoma...
OBJECTIVE
The aim of this study was to show whether local application of cadmium-impregnated bone cement can induce apoptosis and decrease the viability of residual osteosarcoma (OS) cells in nude mice.
METHODS
K7M2 tumorigenic OS cell line was cultivated in vitro. The xenograft tumor model was formed by subcutaneously adding the tumor cells to athymic nude mice. Tumor was formed within 1 month. Then, mice were randomly assigned to five groups, each containing seven nude mice: control (group 1), wide resection (group 2), intralesional resection (group 3), intralesional resection + bone cement (group 4), and intralesional resection + cadmium embedded in bone cement (group 5). Tumor resection with 1 cm surgical margins was performed in the wide resection group. In intralesional resection groups, tumor tissue was resected with positive margins aiming to leave 15 mm3 of macroscopic tumor tissue. In group 3, the defect was left empty; groups 4 and 5 received bone cements prepared with saline and cadmium solutions, respectively. After the resection, mice were observed for 15 days and sacrificed. Next, surgical resection sites were evaluated histopathologically in each group.
RESULTS
Recurrent tumor was formed in all mice in the wide resection group, and apparent progression of residual tumor was observed in groups 3 and 4. On the contrary, only a thin layer of residual tumor was observed around the bone cement in group 5. Histological evaluation revealed remarkable necrosis in group 5 and lowest viability compared to other groups. No systemic toxic effect related to cadmium was observed.
CONCLUSION
Our data suggest that local application of cadmium in bone cement has a significant potential to increase tumor necrosis and decrease the viability of residual OS cells.
Topics: Animals; Apoptosis; Bone Cements; Bone Neoplasms; Cadmium; Cell Survival; Cells, Cultured; Disease Models, Animal; Humans; Mice; Necrosis; Neoplasm Recurrence, Local; Osteosarcoma; Xenograft Model Antitumor Assays
PubMed: 32609089
DOI: 10.5152/j.aott.2020.20247 -
BioMed Research International 2017Knowledge about the elution from antibiotic-loaded cement spacers is an indispensable premise for guarantee of clinical success. A systematic literature search was... (Review)
Review
Knowledge about the elution from antibiotic-loaded cement spacers is an indispensable premise for guarantee of clinical success. A systematic literature search was performed through PubMed. Search terms were "antibiotic elution" and "antibiotic release" in combination with "spacer," "hip spacer," and "knee spacer," respectively. A total of 11 studies could be identified. Seven studies reported on the release of antibiotics after spacer implantation, three studies at spacer removal, and one study on both time points. Seven studies reported on hip spacers, one study on knee spacers, and three studies on both. In eight studies, custom-made spacers have been implanted and in three prefabricated ones. In the majority of the studies, the cement has been loaded with an antibiotic combination, mostly consisting of aminoglycoside (either gentamicin or tobramycin) and vancomycin. Measured concentrations exceeded the minimal inhibitory concentration of the particular pathogen organisms in each case. However, large discrepancies were observed with regard to the height of the antibiotic concentration depending on the antibiotic combination and the antibiotic ratio used. Current literature data indicate a sufficient elution of antibiotics after spacer implantation and at spacer removal, respectively. Future studies are required to optimize the local antibiotic therapy at the site of spacer implantation.
Topics: Anti-Bacterial Agents; Arthroplasty, Replacement, Hip; Bone Cements; Gentamicins; Humans; Knee Joint; Knee Prosthesis; Polymethyl Methacrylate; Prosthesis-Related Infections; Tobramycin; Vancomycin
PubMed: 28656144
DOI: 10.1155/2017/4657874 -
Journal of Cardiothoracic Surgery Aug 2022Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Traditional...
BACKGROUND
Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Traditional treatment methods for DSWI include complete debridement, vacuum sealing drainage wound therapy and sometimes transposition of muscle flap. This study aimed to evaluate the utility of antibiotic-loaded bone cement combined with vacuum sealing drainage on DSWI and explore the effect of this treatment on lung function.
METHODS
Between January 2018 and December 2019, we treated 12 patients suffering a mediastinitis and open thorax using antibiotic-loaded bone cement combined with vacuum sealing drainage. Subsequently, the blood and local concentration of antibiotic were measured. The patient characteristics, pulmonary function, were retrospectively analyzed. Subjects were followed up for 12 months.
RESULTS
There were no intraoperative deaths. All patients' healing wounds were first-stage healing without complications and reoperation, the mean hospital stay was 20.2 ± 3.5 days. Local vancomycin concentrations largely exceeded the ones needed for their efficacy while little antibiotic was found in the blood. Pulmonary function testing was improved 2 weeks after the operation. No infection reoccurred in12-month follow-up.
CONCLUSIONS
The antibiotic-loaded bone cement combined with vacuum sealing drainage might be an effective method for the sternal reconstruction of deep sternal wound infection and it can improve the patient's lung function in a short time.
Topics: Anti-Bacterial Agents; Bone Cements; Debridement; Drainage; Humans; Negative-Pressure Wound Therapy; Retrospective Studies; Surgical Wound Infection; Treatment Outcome
PubMed: 36028875
DOI: 10.1186/s13019-022-01951-2 -
Journal of the Mechanical Behavior of... Feb 2017Aseptic loosening of the tibial component remains the leading cause for revision surgery in total knee arthroplasty (TKA). Understanding the mechanisms leading to loss...
Aseptic loosening of the tibial component remains the leading cause for revision surgery in total knee arthroplasty (TKA). Understanding the mechanisms leading to loss of fixation can offer insight into preventative measures to ensure a longer survival rate. In cemented TKA, loosening occurs at the cement-trabecular interface probably due to a stress-shielding effect of the stiffer implant material in comparison with bone. Using finite element models of lab-prepared tibial cement-trabeculae interface specimens (n=4) based on micro-CT images, this study aims to investigate the micromechanics of the interlock between cement and trabecular bone. Finite element micromotion between cement and trabeculae and bone strain were compared in the interdigitated trabeculae as well as strain in the bone distal to the interface. Lab-prepared specimens and their FE models were assumed to represent the immediate post-operative situation. The cement layer was removed in the FE models while retaining the loading conditions, which resulted in FE models that represented the pre-operative situation. Results showed that micromotion and bone strain decrease when interdigitation depth increases. Bone-cement micromotion and bone strain at the distal interdigitated region showed a dependence on bone volume fraction. Comparing the immediate post-operative and pre-operative situations, trabeculae embedded deep within the cement generally showed the highest level of strain-shielding. Strain shielding of interdigitated bone, in terms of reduction in compressive strains, was found to be between 35 and 61 % for the four specimens. Strain adaptive remodeling could thus be a plausible mechanism responsible for loss of interdigitated bone.
Topics: Arthroplasty, Replacement, Knee; Biomechanical Phenomena; Bone Cements; Cancellous Bone; Finite Element Analysis; Humans; Tibia
PubMed: 27889526
DOI: 10.1016/j.jmbbm.2016.11.006 -
Pain Physician Sep 2022Percutaneous kyphoplasty (PKP) is an effective treatment for osteoporotic vertebral compression fractures (OVCF). Comparisons of different approaches have previously...
Comparison of Unilateral and Bilateral Percutaneous Kyphoplasty for Bone Cement Distribution and Clinical Efficacy: An Analysis Using Three-Dimensional Computed Tomography Images.
BACKGROUND
Percutaneous kyphoplasty (PKP) is an effective treatment for osteoporotic vertebral compression fractures (OVCF). Comparisons of different approaches have previously focused primarily on x-rays. Three-dimensional (3D) computed tomography (CT) enables better imaging evaluation of bone cement distribution.
OBJECTIVES
To compare the CT imaging parameters and clinical efficacies of unilateral and bilateral PKP.
STUDY DESIGN
This was a prospective, nonrandomized controlled study.
SETTING
Department of Orthopedics from an affiliated hospital.
METHODS
Seventy-two single-level OVCF patients who underwent 3D CT between 2018 and 2020 were evaluated prospectively. All patients underwent PKP and were assigned to 2 groups: unilateral PKP and bilateral PKP. Imaging outcomes were assessed by determining the cement volume, leakage, dispersion index, vertebral height (VH) and the cement volume of the noninjected and injected sides. Clinical outcomes were evaluated using the Visual Analog Scale (VAS). The correlations between the bone cement volume or dispersion index and the VAS, VH improvement rate (VHIR), or bone cement leakage were also evaluated.
RESULTS
The mean follow-up time was 17.1 months. The postoperative VH and VAS in both groups were significantly improved (P < 0.05). However, there were no statistically significant differences in the cement volume, leakage or dispersion index, VH, or VAS between the 2 groups. No statistically significant differences in the cement volume or VH were found between the noninjected and injected sides within the unilateral group. The operative time was significantly shorter in the patients who underwent unilateral PKP. Unilateral PKP in which the bone cement did not cross the midline had a higher VAS compared with bilateral PKP. Both the bone cement volume and dispersion index displayed a positive correlation with the VHIR, but no correlation with the VAS or bone cement leakage.
LIMITATIONS
This study was limited by the nonrandomized design, small sample size, and short follow-up period.
CONCLUSIONS
While unilateral PKP was as effective as bilateral PKP, it had a shorter operation time. However, the bilateral PKP approach might be followed when bone cement is distributed in only one side following the unilateral PKP procedure.
Topics: Bone Cements; Fractures, Compression; Humans; Kyphoplasty; Prospective Studies; Spinal Fractures; Thoracic Vertebrae; Tomography, X-Ray Computed
PubMed: 36122263
DOI: No ID Found -
International Journal of Molecular... Dec 2022Calcium phosphate cement (CPC) has been widely studied, but its lack of osteoinductivity and inadequate mechanical properties limit its application, while strontium is...
Calcium phosphate cement (CPC) has been widely studied, but its lack of osteoinductivity and inadequate mechanical properties limit its application, while strontium is able to promote bone formation and inhibit bone resorption. In this study, different proportions of tristrontium silicate were introduced to create a novel strontium-modified calcium phosphate cement (SMPC). The physicochemical properties of SMPC and CPC were compared, and the microstructures of the bone cements were characterized with scanning electron microscopy assays. Then, the effect of SMPC on cell proliferation and differentiation was examined. Furthermore, local inflammatory response and osteogenesis after SMPC implantation were also confirmed in the study. Finally, a rat model of isolated vertebral defects was used to test the biomechanical properties of the cements. The results showed that SMPC has better injectability and a shorter setting time than CPC. Meanwhile, the addition of tristrontium silicate promoted the mechanical strength of calcium phosphate cement, and the compressive strength of 5% SMPC increased to 6.00 ± 0.74 MPa. However, this promotion effect gradually diminished with an increase in tristrontium silicate, which was also found in the rat model of isolated vertebral defects. Furthermore, SMPC showed a more preferential role in promoting cell proliferation and differentiation compared to CPC. Neither SMPC nor CPC showed significant inflammatory responses in vivo. Histological staining suggested that SMPCs were significantly better than CPC in promoting new bone regeneration. Importantly, this osteogenesis effect of SMPC was positively correlated with the ratio of tristrontium silicate. In conclusion, 5% SMPC is a promising substitute material for bone repair with excellent physicochemical properties and biological activity.
Topics: Animals; Rats; Calcium; Bone Cements; Calcium Phosphates; Osteogenesis; Calcium, Dietary; Silicates; Strontium
PubMed: 36614010
DOI: 10.3390/ijms24010568