Polymethylmethacrylate (PMMA) is the most commonly used void filler for augmentation of osteoporotic vertebral fracture, but the differing mechanical features of PMMA and osteoporotic bone result in overload and failure of adjacent bone. The aim of this study was to compare fatigue failure of bone after augmentation with PMMA-nanocrystalline hydroxyapatite (HA) composite material or with plain PMMA in a sheep model. After characterization of the mechanical properties of a composite material consisting of PMMA and defined amounts (10, 20, and 30% volume fraction) of HA, the composite material with 30% volume fraction HA was implanted in one distal femur of sheep; plain PMMA was implanted in the other femur. Native non-augmented bone served as control. Three and 6 months after implantation, the augmented bone samples were exposed to cyclic loading and the evolution of damage was investigated. The fatigue life was highest for the ovine native bone and lowest for bone-PMMA specimens. Bone-composite specimens showed significantly higher fatigue life than the respective bone-PMMA specimens in both 3- and 6-month follow-up groups. These results suggest that modification of mechanical properties of PMMA by addition of HA to approximate those of cancellous bone retards fatigue failure of the surrounding bone compared to augmented bone with plain PMMA. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part B, 102B: 1613–1619, 2014.

REFERENCES

1 Schürch MA, Rizzoli R, Mermillod B, Vasey H, Michel JP, Bonjour JP. A prospective study on socioeconomic aspects of fracture of the proximal femur. J Bone Miner Res 1996; 11(12): 1935–1942.
10.1002/jbmr.5650111215
PubMed Web of Science® Google Scholar
2 Kessenich CR. Non-pharmacological prevention of osteoporotic fractures. Clin Interv Aging 2007; 2(2): 263–266.
PubMed Web of Science® Google Scholar
3 Wilkins CH, Birge SJ. Prevention of osteoporotic fractures in the elderly. Am J Med 2005; 118(11): 1190–1195.
10.1016/j.amjmed.2005.06.046
PubMed Web of Science® Google Scholar
4 Banse X, Sims TJ, Bailey AJ. Mechanical properties of adult vertebral cancellous bone: Correlation with collagen intermolecular cross-links. J Bone Miner Res 2002; 17: 1621–1628.
10.1359/jbmr.2002.17.9.1621
CAS PubMed Web of Science® Google Scholar
5 Boger A, Heini P, Windolf M, Schneider E. Adjacent vertebral failure after vertebroplasty: A biomechanical study of low-modulus PMMA cement. Eur Spine J 2007; 16(12): 2118–2125.
10.1007/s00586-007-0473-0
PubMed Web of Science® Google Scholar
6 Fribourg D, Tang C, Sra P, Delamarter R, Bae H. Incidence of subsequent vertebral fracture after kyphoplasty. Spine 2004; 29: 2270–2276.
10.1097/01.brs.0000142469.41565.2a
PubMed Web of Science® Google Scholar
7 Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: Adjacent fractures occur significantly sooner. Am J Neuroradiol 2006; 27: 217–223.
CAS PubMed Web of Science® Google Scholar
8 Dendorfer S, Maier HJ, Taylor D, Hammer J. Anisotropy of the fatigue behaviour of cancellous bone. J Biomech 2008; 41(3): 636–641.
10.1016/j.jbiomech.2007.09.037
CAS PubMed Web of Science® Google Scholar
9 Haddock SM, Yeh OC, Mummaneni PV, Rosenberg WS, Keaveny TM. Similarity in the fatigue behavior of trabecular bone across site and species. J Biomech 2004; 37(2): 181–187.
10.1016/S0021-9290(03)00245-8
PubMed Web of Science® Google Scholar
10 Rapillard L, Charlebois M, Zysset PK. Compressive fatigue behavior of human vertebral trabecular bone. J Biomech 2006; 39(11): 2133–2139.
10.1016/j.jbiomech.2005.04.033
PubMed Web of Science® Google Scholar
11 Yamamoto E, Crawford RP, Chan DD, Keaveny TM. Development of residual strains in human vertebral trabecular bone after prolonged static and cyclic loading at low load levels. J Biomech 2006; 39(10): 1812–1818.
10.1016/j.jbiomech.2005.05.017
PubMed Web of Science® Google Scholar
12 Boger A, Bohner M, Heini P, Verrier S, Schneider E. Properties of an injectable low modulus PMMA bone cement for osteoporotic bone. J Biomed Mater Res B Appl Biomater 2008; 86(2): 474–482.
10.1002/jbm.b.31044
CAS PubMed Web of Science® Google Scholar
13 Beruto DT, Botter R, Fini M. The effect of water in inorganic microsponges of calcium phosphates on the porosity and permeability of composites made with polymethylmethacrylate. Biomaterials 2002; 23: 2509–2517.
10.1016/S0142-9612(01)00385-4
CAS PubMed Web of Science® Google Scholar
14 Keaveny TM, Pinilla TP, Crawford RP, Kopperdahl DL, Lou A. Systematic and random errors in compression testing of trabecular bone. J Orthop Res 1997; 15(1): 101–110.
10.1002/jor.1100150115
CAS PubMed Web of Science® Google Scholar
15 Moore TL, Gibson LJ. Fatigue of bovine trabecular bone. J Biomech Eng 2003; 125(6): 761–768.
10.1115/1.1631583
PubMed Web of Science® Google Scholar
16 Yang G, Kabel J, van Rietbergen B, Odgaard A, Huiskes A, Cowin SC. The anisotropic hooke's law for cancellous bone and wood. J Elast 1998; 53(2): 125–146.
10.1023/A:1007575322693
CAS PubMed Web of Science® Google Scholar
17 Kessler S, Mayr-Wohlfart U, Ignatius A, Puhl W, Claes L, Günther KP. Histomorphological, histomorphometrical and biomechanical analysis of ceramic bone substitutes in a weight-bearing animal model. J Mater Sci Mater Med 2002; 13: 191–195.
10.1023/A:1013886130805
CAS PubMed Web of Science® Google Scholar
18 Ooms EM, Wolke JG, Van der Waerden JP, Jansen JA. Trabecular bone response to injectable calcium phosphate cement. J Biomed Mater Res 2002; 61: 9–18.
10.1002/jbm.10029
CAS PubMed Web of Science® Google Scholar
19 Schnettler R, Stahl JP, Alt V, Pavlidis T, Dingeldein E, Wenisch S. Calcium phosphate based bone substitutes. Eur J Trauma 2004; 30: 219–229.
10.1007/s00068-004-1393-x
Google Scholar
20 Huber FX, Belyaev O, Hillmeier J, Kock HJ, Huber C, Meeder PJ, Berger I. First histological observations on the incorporation of a novel nanocrystaline hydroxyapatite paste OSTIM in human cancellous bone. BMC Musculoskelet Disord 2006; 7: 50.
10.1186/1471-2474-7-50
CAS PubMed Web of Science® Google Scholar
21 Dahl OE, Garvik LJ, Lyberg T. Toxic effects of methylmethacrylate monomer on leucocytes and endothelial cells in vitro. Acta Orthop Scand 1994; 65: 147–153.
10.3109/17453679408995423
PubMed Web of Science® Google Scholar

Citing Literature

Volume102, Issue8

November 2014

Pages 1613-1619

PMMA-hydroxyapatite composite material retards fatigue failure of augmented bone compared to augmentation with plain PMMA: In vivo study using a sheep model

Abstract

REFERENCES

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

PMMA-hydroxyapatite composite material retards fatigue failure of augmented bone compared to augmentation with plain PMMA: In vivo study using a sheep model

Abstract

REFERENCES

Citing Literature

References

Related

Information