Polymethylmethacrylate bone cements

Webb, J.C.J., Spencer, R.F. 2007. The role of polymethylmethacrylate bone cement in modem orthopaedic surgery. J Bone Joint Surg Br 89(7), 851-857. 

Arora M, Chan EK, Gupta S, Diwan AD. Polymethylmethacrylate bone cements and additives a review of the hterature. World J Qrthop 2013 4 67. 

Bond DM, Rudan J, Kobus SM, Adams MA. Depot local anesthetic in polymethylmethacrylate bone cement a preliminary study. Clin Orthop RelatRes 2004 418 242-245. 

M. Arora, E.K.S. Chan, S. Gupta and A.D. Diwan, Polymethylmethacrylate bone cements and additives A review of the literature. World J. Orthop. 4 67-7A, 2013. 

J.C.J. Webb and R.F. Spencer, The role of polymethylmethacrylate bone cement in modern orthopaedic surgery, /. Bone Joint Surg. Br.89 851-87,2007. 

Two examples of this phenomenon, a vascular graft and a total hip replacement, show how the fibrous capsule which develops around the implant may involve and extrinsically compress other organs. In these two cases, the fibrous encapsulation of an aorto-femoral vascular graft and polymethylmethacrylate bone cement from the acetabular component of the total hip prosthesis, respectively, have also encapsulated a ureter leading to obstruction of the urine flow from the kidney to the bladder. In each of these cases, the fibrous capsule formation is normal, that is, it is no different histologically from fibrous capsules which form around biocompatible polymeric prostheses. 

In describing the components of total joint prostheses and their interaction with adjacent tissues, many authors identify the articulating interface (metal/polymer), the metallic prosthesis - polymethylmethacrylate bone cement interface and the bone cement-bone interface. Unfortunately, the bone cement-bone interface may be transient with a fibrous capsule eventually interposing itself between the bone cement and the bone to create the bone cement-fibrous capsule-bone interface (19,20). As described earlier, the formation of a fibrous capsule around implants is a common occurrence. In the case of total joint prostheses where situ polymerizing methyl methacrylate is used as bone cement, this fibrous capsule formation may be accelerated by the heat of polymerization or the toxicity of the monomer, both of which may lead to localized tissue destruction and cell death (21,22). 

Addition of materials (for example antimicrobial drugs or radio-opaque contrast materials) to acrylic bone cement can cause mechanical weakness due to loss of homogeneity and greater water resorption. Antimicrobial drugs have been added to combat the problem of microbial adherence. However, this can lead to a considerable dead biofilm mass on the polymethylmethacrylate surface, promoting late infections by providing a surface attractive to other strains of bacteria (17). 

Cement is a binder that sets and hardens by itself or binds other materials together. The most widely known application of cements is in construction a second one is the area of bone cements. Cements used in construction are characterized as hydraulic or nonhydraulic and mostly for the production of mortars and concrete. Hydraulic cements set and harden after combining with water. Most construction cements are hydraulic and based on Portland cement, which consists of calcium silicates (at least 2/3 by weight). Nonhydraulic cements include the use of nonhydraulic materials such as lime and gypsum plasters. Bone cements and bone cement composites refer to compounds that have a polymer matrix with a dispersed phase of particles. For instance, polymethylmethacrylate (PMMA) is reinforced with barium sulphate crystals (for radio-opacity) or with hydroxyapatite... 

Bone cement is basically a polymer (polymethylmethacrylate) and may contain 10-... 

PMMA bone cement polymethylmethacrylate based cement for the fixation of endoprostheses... 

Bone cement Mixture of polymethylmethacrylate powder and methylmethacrylate monomer liquid to... 

Fixation of implants with polymethylmethacrylate (PMMA, bone cement) provides immediate stabihty, allowing patients to bare aU of their weight on the extremity at once. In contrast, implants which depend on bone ingrowth require the patient to wait about 12 weeks to bear full weight. 

A few other ceramic nanoparticles have been studied to date for orthopedic applications, most of which, however, are used as additives to other orthopedic materials. For example, bare or functionahzed magnesium oxide, zirconia, barium sulfate, and calcium carbonate are added to polymethylmethacrylate (PMMA) bone cement to reduce the exothermic effect of PMMA while increase its cytocompatibility. X-ray radiopac-ity, as well as antibacterial potential [65],... 

Vallo Cl, Montemartini PE, Fanovich MA (1999) Polymethylmethacrylate-based bone cement modified with hydroxyapatite. J Biraned Mater Res (Appl Biomater) 48 150-158... 

In cemented total joint arthroplasties, acrylic bone cement functions as the piima ry load bearing material used to transfer loads from the implant to the bone. Bone cement Is formed from an exothermic reaction of benzoyl peroxide initiator present In polymethylmethacrylate powder (PMMA) and AI,AI-dimethyl-p-tolui-dene In methylmethacrylate monomer liquid (MMA), resulting in polymerization of PMMA to form a solid cement matrix. The in vivo integrity and performance of bone cement Is necessary for longevity of orthopedic implants, because it is believed that mechanical failure of the bone cement layer can lead to aseptic loosening of the Implant [101]. 

Bone cement Mixture of polymethylmethacrylate powder and methylmethacrylate monomer liquid to be used as a grouting material for the fixation of orthopedic joint implants. 

Fixation of the glenoid component within the bone of the glenoid is generally good, but as noted earlier, it seems to be the weak hnk of TSA. Primary fixation is achieved either with polymethylmethacrylate (PMMA) bone cement or via screws. Cemented all-polyethylene components are widely used, but metal-backed components with bone ingrowth surfaces are also used with cement or supplemental screw fixation. In spite of the radiolucencies seen. 

Acrylic bone cement (PMMA = polymethylmethacrylate), which is used on a growing scale in orthopaedic surgery, has been thoroughly studied and the recent literature throws considerable light on the side effects connected with its use (17 , 21 ). It has become clear that multiple factors are involved and they may produce either direct side effects or lead to insufficient fixation (despite apparently sound surgical techniques) and thereby to complications. 

Lu JX, Huang ZW, Tropiano P (2002) Human bio-logical reactirms at the interface between bone tissue and polymethylmethacrylate cement. J Mater Sci Mater Med 13(8) 803—809... 

Percutaneous cementoplasty (PC) consists of injecting acrylic cement (polymethylmethacrylate) in bone and is a perfect example of a minimally invasive technique in the musculoskeletal system. PC has been performed since 1984. Its role is to consolidate weight-bearing bone and to treat pain. Bone packing with acrylic cement is a procedure aimed at preventing pathological fractures and pain in patients with vertebral body lesions and acetabular metastasis. 

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