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Yang Z, Chen L, Hao Y, Zang Y, Zhao X, Shi L, Zhang Y, Feng Y, Xu C, Wang F, Wang X, Wang B, Liu C, Tang Y, Wu Z, Lei W. Synthesis and Characterization of an Injectable and Hydrophilous Expandable Bone Cement Based on Poly(methyl methacrylate). ACS APPLIED MATERIALS & INTERFACES 2017; 9:40846-40856. [PMID: 29099164 DOI: 10.1021/acsami.7b12983] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Poly(methyl methacrylate) (PMMA), the most common bone cement, has been used as a graft substitute in orthopedic surgeries such as vertebroplasty. However, an undesirable minor crack in the bone-cement interface provoked by shrinkage during polymerization and high elastic modulus of conventional PMMA bone cement dramatically increases the risk of vertebral body refracture postsurgery. Thus, herein, a hydrophilous expandable bone cement was synthesized based on a PMMA commercial cement (Mendec Spine Resin), acrylic acid (AA), and styrene (St). The two synthesized cements (PMMA-PAA, PMMA-PAA-PSt) showed excellent volumetric swelling in vitro and cohesive bone-cement contact in rabbit femur cavity defect. The elastic modulus and compressive strength of the new cements were lower than PMMA. Furthermore, the in vitro analysis indicated that the new cements had lower cytotoxicity than PMMA, including superior proliferation and lower apoptotic rates of Sprague-Dawly rat-derived osteoblasts. Western blotting for protein expression and RT-PCR analysis of osteogenesis-specific genes were conducted on SD rat-derived osteoblasts from both PMMA and new cements films; the results showed that new cements enhanced the expression of osteogenesis-specific genes. Scanning electron microscopy demonstrated improved morphology and attachment of osteoblast on new cement discs compared to the PMMA discs. Additionally, the histological morphologies of the bone-cement interface from the rabbit medial femoral condyle cavity defect model revealed direct and cohesive contact with the bone in the new cement groups in contrast to a minor crack in the PMMA cement group. The sign of a new bone growing into the cement has been found in the new cements after 12 weeks, thereby indicating the osteogenic capacity in vivo. In conclusion, the synthesized hydrophilous expandable bone cements based on PMMA and poly(acrylic acid) (PAA) are promising candidates for vertebroplasty.
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Affiliation(s)
- Zhao Yang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Lei Chen
- School of Materials Science and Engineering, Xi'an University of Technology , No. 5 Jinhua South Road, Xi'an, Shaanxi province 710048, P.R. China
| | - Yuxin Hao
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yuan Zang
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences Beijing, Beijing Institute of Lifeomics , Beijing, 102206, P.R. China
| | - Xiong Zhao
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Lei Shi
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yang Zhang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yafei Feng
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Chao Xu
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Faqi Wang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Xinli Wang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Bowen Wang
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Chenxin Liu
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Yufei Tang
- School of Materials Science and Engineering, Xi'an University of Technology , No. 5 Jinhua South Road, Xi'an, Shaanxi province 710048, P.R. China
| | - Zixiang Wu
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
| | - Wei Lei
- Institute of Orthopaedics, Xijing Hospital, The Fourth Military Medical University , No. 17 Changle Xi Road, Xi'an, Shaanxi province 710032, P.R. China
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Clements J, Walker G, Pentlavalli S, Dunne N. Optimisation of a two-liquid component pre-filled acrylic bone cement system: a design of experiments approach to optimise cement final properties. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:2287-2296. [PMID: 25005558 DOI: 10.1007/s10856-014-5260-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 06/16/2014] [Indexed: 06/03/2023]
Abstract
The initial composition of acrylic bone cement along with the mixing and delivery technique used can influence its final properties and therefore its clinical success in vivo. The polymerisation of acrylic bone cement is complex with a number of processes happening simultaneously. Acrylic bone cement mixing and delivery systems have undergone several design changes in their advancement, although the cement constituents themselves have remained unchanged since they were first used. This study was conducted to determine the factors that had the greatest effect on the final properties of acrylic bone cement using a pre-filled bone cement mixing and delivery system. A design of experiments (DoE) approach was used to determine the impact of the factors associated with this mixing and delivery method on the final properties of the cement produced. The DoE illustrated that all factors present within this study had a significant impact on the final properties of the cement. An optimum cement composition was hypothesised and tested. This optimum recipe produced cement with final mechanical and thermal properties within the clinical guidelines and stated by ISO 5833 (International Standard Organisation (ISO), International standard 5833: implants for surgery-acrylic resin cements, 2002), however the low setting times observed would not be clinically viable and could result in complications during the surgical technique. As a result further development would be required to improve the setting time of the cement in order for it to be deemed suitable for use in total joint replacement surgery.
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Affiliation(s)
- James Clements
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Stranmillis Road, Belfast, BT9 5AH, UK
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Brochu ABW, Evans GA, Reichert WM. Mechanical and cytotoxicity testing of acrylic bone cement embedded with microencapsulated 2-octyl cyanoacrylate. J Biomed Mater Res B Appl Biomater 2013; 102:181-9. [PMID: 23913367 DOI: 10.1002/jbm.b.32994] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 05/29/2013] [Accepted: 06/06/2013] [Indexed: 11/10/2022]
Abstract
The water-reactive tissue adhesive 2-octyl cyanoacrylate (OCA) was microencapsulated in polyurethane shells and incorporated into Palacos R bone cement. The tensile and compressive properties of the composite material were investigated in accordance with commercial standards, and fracture toughness of the capsule-embedded bone cement was measured using the tapered double-cantilever beam geometry. Viability and proliferation of MG63 human osteosarcoma cells after culture with extracts from Palacos R bone cement, capsule-embedded Palacos R bone cement, and OCA were also analyzed. Incorporating up to 5 wt % capsules had little effect on the compressive and tensile properties of the composite, but greater than 5 wt % capsules reduced these values below commercial standards. Fracture toughness was increased by 13% through the incorporation of 3 wt % capsules and eventually decreased below the toughness of the capsule-free controls at capsule contents of 15 wt % and higher. The effect on cell proliferation and viability in response to extracts prepared from capsule-embedded and commercial bone cements were not significantly different from each other, whereas extracts from OCA were moderately toxic to cells. Overall, the addition of lower wt % of OCA-containing microcapsules to commercial bone cement was found to moderately increase static mechanical properties without increasing the toxicity of the material.
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Affiliation(s)
- Alice B W Brochu
- Department of Biomedical Engineering, Duke University, 136 Hudson Hall, Box 90281, Durham, North Carolina, 27708; Center for Biomolecular and Tissue Engineering, Duke University, 136 Hudson Hall, Box 90281, Durham, North Carolina, 27708
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