Implications of ageing effects on thermal and mechanical properties of PMMA-based bone cement for THA revision surgery

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  • Medizinische Hochschule Hannover (MHH)
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OriginalspracheEnglisch
Aufsatznummer106218
FachzeitschriftJournal of the Mechanical Behavior of Biomedical Materials
Jahrgang148
Frühes Online-Datum31 Okt. 2023
PublikationsstatusVeröffentlicht - Dez. 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.

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Implications of ageing effects on thermal and mechanical properties of PMMA-based bone cement for THA revision surgery. / Reulbach, Magnus; Evers, Patrick; Emonde, Crystal et al.
in: Journal of the Mechanical Behavior of Biomedical Materials, Jahrgang 148, 106218, 12.2023.

Publikation: Beitrag in FachzeitschriftArtikelForschungPeer-Review

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title = "Implications of ageing effects on thermal and mechanical properties of PMMA-based bone cement for THA revision surgery",
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{\textregistered} 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",
author = "Magnus Reulbach and Patrick Evers and Crystal Emonde and Hannah Behnsen and Florian N{\"u}rnberger and Henning Windhagen and Eike Jakubowitz",
note = "Funding Information: Funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB/TRR-298-SIIRI – Project-ID 426335750 .",
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language = "English",
volume = "148",
journal = "Journal of the Mechanical Behavior of Biomedical Materials",
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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.

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KW - In-vitro ageing

KW - PMMA-based bone cement

KW - Revision surgery

KW - Total hip arthroplasty

KW - Vicat softening temperature

KW - Water uptake

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DO - 10.1016/j.jmbbm.2023.106218

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VL - 148

JO - Journal of the Mechanical Behavior of Biomedical Materials

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