Development and Characterization of Acrylic Based Bone Cements

Bone tissue engineering has emerged as a multidisciplinary field in recent times with an aim to expedite the process of regeneration of damaged or diseased tissues. This study is an attempt to fabricate and characterize Tricalcium Phosphate (TCP) and Chitosan incorporated Polymethylmethacrylate (PMMA) based bone cement. In total two experimental PMMA based bone cements were fabricated that were differentiated by presence and absence of Chitosan. In both groups (10 and 30 wt.%) TCP were incorporated into Methyl methacrylate (MMA) monomer. PMMA was used as a control. The physical, mechanical and thermal properties of the composites were assessed. Morphological changes of PMMA after the introduction of TCP and Chitosan were observed by means of X-ray diffraction (XRD). Major peak shifts in Fourier transform Infrared spectroscopy (FTIR) spectra demonstrated the strong bonding of PMMA with incorporated materials. PMMA incorporated with 10% TCP showed the maximum wettability in absence of Chitosan. Hardness of the tested specimens decreased with increasing content of TCP which in turns enhanced ductility. It was also observed that neither of the samples showed significant degradation. The incorporation of additives enhance the physical and chemical properties of PMMA as bone cement.

All that clots is not blood: Bone cement implantation syndrome presenting as an intracardiac mass and pulmonary embolism

Bone cement implantation syndrome (BCIS) is a rare and potentially fatal perioperative complication of cemented orthopaedics surgery. A CT-pulmonary angiogram and echocardiogram images were acquired from an 88-year-old patient who had a perioperative collapse while undergoing a revision operation for a peri-implant fracture of the right femoral neck. Findings were suggestive of an intracardiac clot connected to a saddle pulmonary artery embolus. Patient also developed disseminated intravascular coagulation. Overall findings were suggestive of bone cement implantation syndrome.

The Development of a Magnesium-Releasing and Long-Term Mechanically Stable Calcium Phosphate Bone Cement Possessing Osteogenic and Immunomodulation Effects for Promoting Bone Fracture Regeneration

Bone grafts are commonly used for the treatment of critical sized bone defects. Since the supply of autologous bone is insufficient, allogeneic bone grafts have been used most of the time. However, the poor osteogenic property of allogeneic bone grafts after pretreatment results in delayed union, non-union, or even occasional deformity. Calcium phosphate cement (CPC) is one of the most promising bone filling materials due to its good biocompatibility and similar chemical components as natural bone. However, clinical applications of CPC were hampered by limited osteogenic effects, undesired immune response which results in resorption, and poor mechanical stability in vivo. Magnesium (Mg) has been proven to trigger bone regeneration through modulating cell behaviors of mesenchymal stem cells and macrophages significantly. Unfortunately, the degradation raters of pure Mg and Mg oxide are extremely fast, resulting in early collapse of Mg contained CPC. In this study, we developed a novel magnesium contained calcium phosphate bone cement (Mg-CPC), possessing long-term mechanical stability and osteogenic effects through sustained release of Mg. Furthermore, in vitro studies showed that Mg-CPC had no cytotoxic effects on hBMMSCs and macrophage RAW 264.7, and could enhance the osteogenic differentiation as determined by alkaline phosphate (ALP) activity and calcium nodule staining, as well as suppress the inflammatory as determined by expression of anti-inflammatory cytokine IL-1RA. We also found that Mg-CPC promoted new bone formation and bone maturation in vivo. These results suggest that Mg-CPC should be a good substitute material for bone grafts in clinical use.

The Effect of Kryptonite Bone Cement combined with a Standard Kirschner Wire on Tibial Bone Fracture in Rats

Objective This study aims to observe whether Kryptonite Bone Cement combined with a standard Kirschner wire, instead of autogenous bone grafts, increases bone healing and mechanical strength in rats with tibia fractures. Methods The study included sixteen rats, which were divided into two groups as a control group (n=8) and an experimental group (n=8). After segmental fractures were made in both groups, intramedullary fixation of tibia procedures were conducted with the use of a Kirschner wire. No additional procedures were performed inthe control group, but Kryptonite Bone Cement was applied in the experimental group. The rats were evaluated clinically, radiologically and histologically4 times; immediately after the operation, and atthe 1st, 3rd, and 6thweeks following surgery. Results One rat from the experimental and one from the control group had both wound dehiscence and wound site infection. No recovery was observed in any rats either in the control or experimental group immediately after surgery. During week 1, callus formation was identified in 5 rats in the experimental group (p=0.0072), and during week 3, fracture lines disappeared in 4 rats in the experimental group (p=0.064); the differences between control and experimental groups were statistically significant. During week 6, no statistical significance was observed in radiological assessments for the control group and experimental group (p=0.71). The rate of non-union was higher in the control group (37.50%) than in the experimental one, while the rate of complete fusion was higher in the experimental group (87.50%) than that in the control group. Conclusion Osteoconductivity and ergonomic qualities of Kryptonite Bone Cement prove helpful in bone repair. Future studies to be conducted in a prospective and randomized manner will be effective on demonstrating the effectiveness of Kryptonite Bone Cement.

Clinical Application of a Modified Bone Cement Pusher in Percutaneous Vertebroplasty Combined with Multi-Target Negative Pressure Rotary-Cutting Technique in Puncture Biopsy for Bone Tumors

Purpose To assess the efficiency and safety of a modified bone cement pusher in percutaneous vertebroplasty (PVP) combined with a multi-target negative pressure rotary-cutting technique in puncture biopsy of bone tumors. Methods The biopsy performed with the modified bone cement pusher commonly used in PVP, and a multi-target negative pressure rotary-cutting technique. A total of 120 patients with spinal and pelvic tumors undergoing needle biopsy in our department were recruited and assigned to new biopsy device group (group A, n=60) or and conventional biopsy device group (group B, n=60). The puncture time, positive rate, consistency rate, and dependence rate between group A and B were compared to assess the efficiency and safety of the new device. Results No biopsy-related complications were reported in both groups. The puncture time (39.44±8.885 min vs. 61.61±9.880 min), positive rate (96.67% vs. 61.67%), consistency rate (96.55% vs. 81.8%), and dependence rate (100% vs. 83.33%) were significantly superb in group A compared with those in group B (all P<0.05). Patients in group A did not require repeated biopsies, and sufficient samples were obtained through the needle trajectory in PVP. All patients with a definite diagnosis were managed with appropriate treatments. Conclusions Featuring high safety, positive rate and consistency rate, the new device can be performed to collect sufficient pathological samples from multiple angles. Wide clinical replication can be expected considering its evident diagnostic efficiency for bone tumor.