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Anatolian Journal of Cardiology Mar 2022
Topics: Bone Cements; Heart Injuries; Humans
PubMed: 35346920
DOI: 10.5152/AnatolJCardiol.2021.1404 -
AANA Journal Dec 2018Bone cement implantation syndrome (BCIS) is a rare and potentially fatal perioperative complication of cemented bone surgery. Clinically, it can be as benign as... (Review)
Review
Bone cement implantation syndrome (BCIS) is a rare and potentially fatal perioperative complication of cemented bone surgery. Clinically, it can be as benign as transient desaturation or mild hypotension. In its more severe presentation, BCIS can cause serious cardiac dysrhythmias and cardiac arrest, and in cemented hemiarthroplasty for femoral neck fracture, BCIS may carry up to a 16-fold increase in 30-day postoperative mortality. The etiology and pathophysiology of BCIS are not fully established; however, results of studies and clinical reports are consistent, citing right ventricular failure secondary to increased pulmonary artery pressure as the cause of systemic hypotension and sudden cardiac arrest. The purpose of this article was to review the literature for a comprehensive understanding of bone cement and BCIS. This article reviews the history of bone cement and its associated hazards, etiology/ pathophysiology and clinical presentation of BCIS, preoperative assessment and planning for cemented procedures, anesthetic management of BCIS, and the surgeon's role in reducing the risk of BCIS.
Topics: Arthroplasty, Replacement, Hip; Bone Cements; Humans; Hypotension; Intraoperative Complications; Nurse Anesthetists; Syndrome
PubMed: 31584416
DOI: No ID Found -
JBJS Reviews Dec 2019
Review
Topics: Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Bone Cements; Humans; Polymethyl Methacrylate
PubMed: 31880624
DOI: 10.2106/JBJS.RVW.19.00031 -
Orthopadie (Heidelberg, Germany) Dec 2023There is widespread consensus that adjuvant local use of antimicrobial agents in combination with their systemic administration can better prevent and treat... (Review)
Review
BACKGROUND
There is widespread consensus that adjuvant local use of antimicrobial agents in combination with their systemic administration can better prevent and treat implant-associated musculoskeletal infections. The advantage of local antibiotics lies in their particular pharmacokinetics with initially high antibiotic concentrations at the implant site with only low systemic uptake.
AIM OF TREATMENT
The aim of local application is to protect the foreign bodies directly at the implantation site from bacterial colonization and biofilm formation (prophylaxis) and to support the eradication of an already established infection after surgical debridement (treatment). Since the observations of Prof. Buchholz, bone cement has been the most frequently used local carrier system.
APPLICATION
In cases of infection, surgeons should ideally work together with microbiologists, infectiologists or clinical pharmacists to determine which anti-infective agents are indicated systemically for the patient and which ones are indicated locally with PMMA cement, based on the pathogen(s) and antibiograms. However, for the anti-infective agents administered with bone cement, there is still uncertainty about which agents can be added to this carrier material and at what concentrations. Accordingly, the authors of this review article not only summarize the rationale and evidence for local antibiotic use but also elaborate on the points that must be considered for admixing these agents to the cement.
Topics: Humans; Anti-Bacterial Agents; Bone Cements; Anti-Infective Agents; Arthroplasty, Replacement; Postoperative Complications
PubMed: 37831092
DOI: 10.1007/s00132-023-04447-6 -
Journal of the Mechanical Behavior of... May 2022A non-leaching antibacterial bone cement has been developed and evaluated. Chlorine- and bromine-containing furanone derivatives were synthesized and covalently coated...
A non-leaching antibacterial bone cement has been developed and evaluated. Chlorine- and bromine-containing furanone derivatives were synthesized and covalently coated onto the surface of zirconia filler particles, followed by mixing into a conventional poly(methyl methacrylate) bone cement. Flexural strength and bacterial viability were used to evaluate the modified cements. Effects of coated antibacterial moiety content, coated zirconia loading and halogen on furanone were investigated. Results showed that the experimental cement showed significant enhanced antibacterial function against bone-associated Gram-positive Staphylococcus aureus as well as Gram-negative Pseudomonas aeruginosa, as compared to commercial PMMA cement. The cement also exhibited a comparable flexural strength to and 3-14% higher flexural modulus than commercial PMMA bone cement. Increasing antibacterial moiety content and filler loading significantly enhanced antibacterial activity. Increasing antibacterial moiety content slightly increased both flexural strength and modulus of the modified cement. Increasing filler loading slightly increased flexural strength up to 7% loading and then decreased. The bromine-containing furanone modified cement showed a higher antibacterial activity than its chlorine counterpart. Antibacterial agent leaching tests exhibited that the modified experimental cement showed no leachable antibacterial components to surroundings. Within the limitations of this study, this experimental poly(methyl methacrylate) cement may find potential applications in orthopedics for reducing in-surgical and post-surgical infection after further investigations are conducted.
Topics: Anti-Bacterial Agents; Bone Cements; Bromine; Chlorine; Glass Ionomer Cements; Materials Testing; Polymethyl Methacrylate; Zirconium
PubMed: 35279449
DOI: 10.1016/j.jmbbm.2022.105135 -
Journal of Perioperative Practice Sep 2011Bone cement has been increasingly used in orthopaedic surgery over the last 50 years. Since Sir John Charnley pioneered the use of polymethylmethacrylate cement in total... (Review)
Review
Bone cement has been increasingly used in orthopaedic surgery over the last 50 years. Since Sir John Charnley pioneered the use of polymethylmethacrylate cement in total hip replacements, there have been developments in cementing techniques and an expansion in the number of orthopaedic procedures that use cement. This review covers the perioperative issues surrounding bone cement including storage, cementing techniques and complications. It also discusses specific orthopaedic applications of bone cement and future developments.
Topics: Arthroplasty, Replacement; Bone Cements; Cementation; Humans; Polymethyl Methacrylate
PubMed: 22474774
DOI: 10.1177/175045891102100902 -
Journal of Biomedical Materials... Jul 2019Vertebroplasty procedures provide a significant benefit for patients suffering from vertebral fractures. In order to address current issues of vertebroplasty procedures,...
Vertebroplasty procedures provide a significant benefit for patients suffering from vertebral fractures. In order to address current issues of vertebroplasty procedures, an injection device able to control the bone cement viscosity has been developed. In addition, this device allows to protect the practitioner by removing him/her from the X-rays area. In this context, a study is first proposed to quantify the bone cement viscosity during its polymerization reaction on a rotational rheometer. These experimental measurements have led to the identification of a complete behavior law that takes into account the simultaneous effects of shear rate, time, and temperature. Based on this preliminary study, this article finally aims to prove the ability of estimating the viscosity of the flowing bone cement on the developed injection system. A final set of experiments validates that the injection device dedicated to vertebroplasty procedures can control the flowing bone cement viscosity by acting on the temperature. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1504-1515, 2019.
Topics: Bone Cements; Polymethyl Methacrylate; Spinal Fractures; Vertebroplasty; Viscosity
PubMed: 30267639
DOI: 10.1002/jbm.b.34242 -
Bio-medical Materials and Engineering 2022Bone cements aid in bone regeneration; however, if the handling time is not well established for the material to harden, complications may arise.
BACKGROUND
Bone cements aid in bone regeneration; however, if the handling time is not well established for the material to harden, complications may arise.
OBJECTIVE
This work investigates the effect of using polyethylene glycol (PEG) and characterize it in brushite bone cement in order to obtain desirable handling times as well as its regeneration in vivo to analyse if addition of this polymer may significantly modify its properties.
METHODS
PEG 4000 was synthesised with wollastonite by phosphorization reaction in order to form brushite which was further cured by oven drying. They were further characterised and tested in vivo as tibial bone defect model using rabbits.
RESULTS
Addition of PEG exhibited handling times of 60 min with a low increase in temperature when curing. Brushite phase of ∼71% was obtained after cement hardening with good compressive strength (25 MPa) and decent values of porosity (33%). In vivo presented that, at 40 days postoperatively, accelerated bone neoformation with partial consolidation at 30 days and total after 60 days when using bone cement.
CONCLUSIONS
Addition of PEG does not disrupt the beneficial properties of the bone cement and can be a potential alternative to control the time-temperature profile of hardening these materials.
Topics: Animals; Bone Cements; Bone Regeneration; Calcium Phosphates; Compressive Strength; Materials Testing; Polyethylene Glycols; Rabbits
PubMed: 34864647
DOI: 10.3233/BME-211308 -
Journal of Biomaterials Science.... Aug 2022A novel non-leaching antibacterial bone cement has been developed and evaluated. An antibacterial furanone derivative was synthesized and covalently coated onto the...
A novel non-leaching antibacterial bone cement has been developed and evaluated. An antibacterial furanone derivative was synthesized and covalently coated onto the surface of alumina filler particles, followed by mixing into a conventional poly(methyl methacrylate) bone cement. Flexural strength and bacterial viability were used to evaluate the modified cements. Effects of coated antibacterial moiety content, coated alumina filler particle size and loading were investigated. Results showed that almost all the modified cements showed higher flexural strength (up to 10%), flexural modulus (up to 18%), and antibacterial activity (up to 67% to and up to 84% to ), as compared to original poly(methyl methacrylate) cement. Increasing antibacterial moiety and filler loading significantly enhanced antibacterial activity. On the other hand, increasing coated filler particle size decreased antibacterial activity. Increasing antibacterial moiety content and particle size did not significantly affect flexural strength and modulus. Increasing filler loading did not significantly affect flexural modulus but reduced flexural strength. Antibacterial agent leaching tests showed that it seems no leachable antibacterial component from the modified experimental cement to the surrounding environment. Within the limitations of this study, the modified poly(methyl methacrylate) bone cement may potentially be developed into a clinically useful bone cement for reducing in-surgical and post-surgical infection.
Topics: Aluminum Oxide; Anti-Bacterial Agents; Bone Cements; Escherichia coli; Flexural Strength; Materials Testing; Polymethyl Methacrylate; Staphylococcus aureus
PubMed: 35321628
DOI: 10.1080/09205063.2022.2056943 -
Small (Weinheim An Der Bergstrasse,... Apr 2023Interest in the development of new generation injectable bone cements having appropriate mechanical properties, biodegradability, and bioactivity has been rekindled with...
Interest in the development of new generation injectable bone cements having appropriate mechanical properties, biodegradability, and bioactivity has been rekindled with the advent of nanoscience. Injectable bone cements made with calcium sulfate (CS) are of significant interest, owing to its compatibility and optimal self-setting property. Its rapid resorption rate, lack of bioactivity, and poor mechanical strength serve as a deterrent for its wide application. Herein, a significantly improved CS-based injectable bone cement (modified calcium sulfate termed as CS ), reinforced with various concentrations (0-15%) of a conductive nanocomposite containing gold nanodots and nanohydroxyapatite decorated reduced graphene oxide (rGO) sheets (AuHp@rGO), and functionalized with vancomycin, is presented. The piezo-responsive cement exhibits favorable injectability and setting times, along with improved mechanical properties. The antimicrobial, osteoinductive, and osteoconductive properties of the CS cement are confirmed using appropriate in vitro studies. There is an upregulation of the paracrine signaling mediated crosstalk between mesenchymal stem cells and human umbilical vein endothelial cells seeded on these cements. The ability of CS to induce endothelial cell recruitment and augment bone regeneration is evidenced in relevant rat models. The results imply that the multipronged activity exhibited by the novel-CS cement would be beneficial for bone repair.
Topics: Rats; Animals; Humans; Bone Cements; Durapatite; Gold; Calcium Sulfate; Endothelial Cells; Nanocomposites; Bone Regeneration; Calcium Phosphates; Compressive Strength
PubMed: 36642859
DOI: 10.1002/smll.202204637