Details
| Original language | English |
|---|---|
| Article number | 106218 |
| Journal | Journal of the Mechanical Behavior of Biomedical Materials |
| Volume | 148 |
| Early online date | 31 Oct 2023 |
| Publication status | Published - Dec 2023 |
Abstract
Loosening and infection are the main reasons for revision surgery in total hip arthroplasty (THA). Removing partially detached cemented implant components during revision surgery remains challenging and poses the risk of periprosthetic bone damage. A promising approach for a gentler removal of partially detached prostheses involves softening the PMMA-based bone cement by heating it above its glass transition temperature (TG), thus loosening the implant-cement bond. It is assumed that the TG of PMMA-based bone cement decreases in-vivo due to the gradual absorption of body fluid. Reliable data on TG are essential to develop a heat-based method for removing cemented implant components during revision surgery. The effect of water absorption was investigated in-vitro by ageing PMMA-based bone cement samples for different periods up to 56 days in both Ringer's solution (37 °C) and air (37 °C and 30% humidity). Subsequently, the TG and Vicat softening temperatures of the samples were determined by differential scanning calorimetry and Vicat tests, respectively, according to prescribed methods. Over the entire ageing period, i.e. comparing one day of ageing in air and 56 days in Ringer's solution, the Vicat softening temperature dropped by 16 °C, while the TG dropped by 10 °C for Palacos® R PMMA-based bone cement. Water absorption over time correlated significantly with the Vicat softening temperature until saturation of the PMMA-based bone cement was reached. Based on the TG and Vicat softening temperature measurements, it can be assumed that in body-aged bone cement, an optimal softening can be achieved within a temperature range of 85 °C–93 °C to loosen the bond between the PMMA-based bone cement mantle and the prosthesis stem. These findings may pave the way for a gentler removal of the implant in revision THA.
Keywords
- Glass transition temperature, In-vitro ageing, PMMA-based bone cement, Revision surgery, Total hip arthroplasty, Vicat softening temperature, Water uptake
ASJC Scopus subject areas
- Materials Science(all)
- Biomaterials
- Engineering(all)
- Biomedical Engineering
- Engineering(all)
- Mechanics of Materials
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In: Journal of the Mechanical Behavior of Biomedical Materials, Vol. 148, 106218, 12.2023.
Research output: Contribution to journal › Article › Research › peer review
}
TY - JOUR
T1 - Implications of ageing effects on thermal and mechanical properties of PMMA-based bone cement for THA revision surgery
AU - Reulbach, Magnus
AU - Evers, Patrick
AU - Emonde, Crystal
AU - Behnsen, Hannah
AU - Nürnberger, Florian
AU - Windhagen, Henning
AU - Jakubowitz, Eike
N1 - Funding Information: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB/TRR-298-SIIRI – Project-ID 426335750 .
PY - 2023/12
Y1 - 2023/12
N2 - Loosening and infection are the main reasons for revision surgery in total hip arthroplasty (THA). Removing partially detached cemented implant components during revision surgery remains challenging and poses the risk of periprosthetic bone damage. A promising approach for a gentler removal of partially detached prostheses involves softening the PMMA-based bone cement by heating it above its glass transition temperature (TG), thus loosening the implant-cement bond. It is assumed that the TG of PMMA-based bone cement decreases in-vivo due to the gradual absorption of body fluid. Reliable data on TG are essential to develop a heat-based method for removing cemented implant components during revision surgery. The effect of water absorption was investigated in-vitro by ageing PMMA-based bone cement samples for different periods up to 56 days in both Ringer's solution (37 °C) and air (37 °C and 30% humidity). Subsequently, the TG and Vicat softening temperatures of the samples were determined by differential scanning calorimetry and Vicat tests, respectively, according to prescribed methods. Over the entire ageing period, i.e. comparing one day of ageing in air and 56 days in Ringer's solution, the Vicat softening temperature dropped by 16 °C, while the TG dropped by 10 °C for Palacos® R PMMA-based bone cement. Water absorption over time correlated significantly with the Vicat softening temperature until saturation of the PMMA-based bone cement was reached. Based on the TG and Vicat softening temperature measurements, it can be assumed that in body-aged bone cement, an optimal softening can be achieved within a temperature range of 85 °C–93 °C to loosen the bond between the PMMA-based bone cement mantle and the prosthesis stem. These findings may pave the way for a gentler removal of the implant in revision THA.
AB - Loosening and infection are the main reasons for revision surgery in total hip arthroplasty (THA). Removing partially detached cemented implant components during revision surgery remains challenging and poses the risk of periprosthetic bone damage. A promising approach for a gentler removal of partially detached prostheses involves softening the PMMA-based bone cement by heating it above its glass transition temperature (TG), thus loosening the implant-cement bond. It is assumed that the TG of PMMA-based bone cement decreases in-vivo due to the gradual absorption of body fluid. Reliable data on TG are essential to develop a heat-based method for removing cemented implant components during revision surgery. The effect of water absorption was investigated in-vitro by ageing PMMA-based bone cement samples for different periods up to 56 days in both Ringer's solution (37 °C) and air (37 °C and 30% humidity). Subsequently, the TG and Vicat softening temperatures of the samples were determined by differential scanning calorimetry and Vicat tests, respectively, according to prescribed methods. Over the entire ageing period, i.e. comparing one day of ageing in air and 56 days in Ringer's solution, the Vicat softening temperature dropped by 16 °C, while the TG dropped by 10 °C for Palacos® R PMMA-based bone cement. Water absorption over time correlated significantly with the Vicat softening temperature until saturation of the PMMA-based bone cement was reached. Based on the TG and Vicat softening temperature measurements, it can be assumed that in body-aged bone cement, an optimal softening can be achieved within a temperature range of 85 °C–93 °C to loosen the bond between the PMMA-based bone cement mantle and the prosthesis stem. These findings may pave the way for a gentler removal of the implant in revision THA.
KW - Glass transition temperature
KW - In-vitro ageing
KW - PMMA-based bone cement
KW - Revision surgery
KW - Total hip arthroplasty
KW - Vicat softening temperature
KW - Water uptake
UR - http://www.scopus.com/inward/record.url?scp=85176465531&partnerID=8YFLogxK
U2 - 10.1016/j.jmbbm.2023.106218
DO - 10.1016/j.jmbbm.2023.106218
M3 - Article
C2 - 37931550
AN - SCOPUS:85176465531
VL - 148
JO - Journal of the Mechanical Behavior of Biomedical Materials
JF - Journal of the Mechanical Behavior of Biomedical Materials
SN - 1751-6161
M1 - 106218
ER -