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Long-term mechanical properties of a low-modulus bone cement for the treatment of vertebral compression fractures
Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Applied Materials Sciences.ORCID iD: 0000-0003-4139-6913
(English)In: Article in journal (Other (popular science, discussion, etc.)) In press
Keyword [en]
Acrylic bone cement, low-modulus, elastic modulus, compression, fatigue, vertebroplasty
National Category
Materials Engineering
Research subject
Engineering Science with specialization in Materials Science
Identifiers
URN: urn:nbn:se:uu:diva-349059OAI: oai:DiVA.org:uu-349059DiVA, id: diva2:1199300
Available from: 2018-04-20 Created: 2018-04-20 Last updated: 2018-04-20
In thesis
1. Bone-compliant cements for vertebral augmentation
Open this publication in new window or tab >>Bone-compliant cements for vertebral augmentation
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Acrylic bone cement based on poly(methyl methacrylate) (PMMA) is commonly used during vertebral augmentation procedures for the treatment of osteoporosis-induced vertebral compression fractures. However, the high stiffness of the cement compared to that of the surrounding trabecular bone is presumed to facilitate the formation of new fractures shortly after surgery. The aim of the thesis was to develop and evaluate a PMMA-based bone cement that better matches the mechanical properties of vertebral trabecular bone. To fulfill this objective, different compounds were added to the initial formulation of bone cement to modify its functional properties. Linoleic acid (LA) was found to give the best combination of strength and stiffness without negative effects on the handling properties and its use was therefore further investigated. In particular, different application-specific mechanical properties of LA-modified cement as well as itsin vivoperformance in an ovine model were assessed. 

In summary, LA-modified cement exhibited bone-compliant mechanical properties immediately after incorporation of the additive, as well as adequate handling properties, in particular a lower polymerization temperature and appropriate setting time. The screw pullout strength from low-modulus cement was substantially reduced compared to regular PMMA cement, but comparable to some calcium phosphate based cements. The fatigue limit of LA-modified cement was considerably lower compared to regular PMMA bone cement when tested in physiological solution, but still higher than stresses measured in the spine during daily activities. The modified cement displayed similar inflammatory response in vivoto conventional cement, with no evidence of additional cytotoxicity due to the presence of LA. Finally, it was possible to sterilize the additive without significantly compromising its function in the PMMA cement.

The results from this thesis support further evaluation of the material towards the intended clinical application. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 92
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 1676
Keyword
bone cement, low modulus, vertebroplasty
National Category
Materials Engineering
Research subject
Engineering Science with specialization in Materials Science
Identifiers
urn:nbn:se:uu:diva-349028 (URN)978-91-513-0351-2 (ISBN)
Public defence
2018-06-07, Häggsalen, Ångströmlaboratoriet, Lägerhyddsvägen 1, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2018-05-16 Created: 2018-04-20 Last updated: 2018-05-16

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