Bone Cement And Its Application

With an increasing number of bone cements available, it is vital that the correct material is selected for specific clinical procedures. A review of the most recent research in this field, this book covers such topics as hip replacements, verteboplasty and wear particles and osteolysis. It reviews materials and types of cement such as acrylic, polymethylmethacrylate and calcium phosphate cements and address the mechanical properties of bone cements such as fracture toughness and dynamic creep. The book closes with an examination of methods to enhance the properties of bone cements such as antibiotic loaded bone cements and bioactive cements.

Methyl methacrylate (MMA) is the basic component of bone cements. To use it, a dough is prepared from the liquid and powder by mixing right before application, which is normally done by the operating team. During its working phase the dough is then inserted into the tissue where polymerization is completed. Thus, the final implant polymethyl methacrylate (PMMA) is only created at the implantation site. Besides methyl methacrylate, bone cements sometimes contain other methacrylates, such as butyl methacrylate. To achieve X-ray opacity, radiopacifiers (zirconium dioxide or barium sulfate) are added to the powder. Both the liquid and powder components contain additives (initiator and activator) that launch polymerization and control the set ting when mixed together. Moreover, softener and emulsifiers are some times used. The addition of antibiotics to the powder component in order to prevent or treat infections has become especially important. Commercial bone cements differ in composition and the course of curing. Some are designed for high and others for low viscosity. The way the user handles and applies the cement always crucially influences the quality of the implant. This is why clear and comprehensive information about the cements should be available to show the user how all the relevant factors work It should also be possible together and how they depend on each other.

G. H. I. M. WALENKAMP, D. W. MURRAY Since the first use of bone cement, there has been much discussion about this important tool in arthroplasty. Many authors consider the cemented prosthesis as the gold standard when evaluating the outcome of primary prostheses. In a large number of total hip arthroplasties, as registered in the Scandi navian Hip Registers, important differences in revision risks have been docu mented between hospitals. These differences are partly due to the use of di verse cement techniques. In the analysis of data, the influence of these tech niques, as well as the different cement types, is clear. A recent disaster with a newly developed cement also illustrated that the quality of the cement must be assured, and that the introduction of a new material must be carefully prepared and followed-up. The new Palamed cement has been developed by the makers of the well known Palacos and Refobacin Palacos, which appeared to be the best ce ments in the Swedish register. An improvement was noted in slightly better handling characteristics, but the end product is the same as Palacos. As men tioned, this cement will be carefully followed-up in the near future. However, its introduction is a good reason to gather the expertise of some of the lead ing figures in the field in this book. II History of Bone Cements CHAPTER 2. 1 Industrial Development of Bone Cement Twenty-Five Years of Experience w. EGE, K. D.

Cemented Total Hip Arthroplasty (THA) remains one of the most successful procedures in Orthopaedic surgery. It has become very clear that it is the surgical expertise, in particular the quality of the cementing technique, which will affect long-term outcome and success. It is the intention of this book to provide an up-to-date comprehensive assessment of the entire field of cemented THA. Special emphasis has been given to practice-relevant aspects: well-illustrated and detailed operative steps as a practical guideline, a basic science chapter and long-term outcome data are provided. Minimally invasive surgery, modern perioperative management and patient fast tracking are covered. A number of highly respected experts have contributed to this in-depth compilation of the "state of the art" in 2005. This book is written and intended for both, trainees and established arthroplasty surgeons who are dedicated to perform a well-cemented THA.

This book provides an overview of the composition of polymeric and ceramic bone cements. It also discusses complex, biomimetic structures based on biomaterials, such as cells and bioactive molecules, which more closely resemble natural bone The first chapter describes the main concepts of the cementation process and the parameters affecting it, while the second chapter focuses on the composition and structure of candidate biomaterials. Lastly, the third and fourth chapters present recent research aimed at improving the ability of naked biomaterials to enhance bone healing by adding cells and bioactive agents.

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