Role of fast-setting cements in arthroplasty: A comparative analysis of characteristics

作     者：Neil Ayron Caraan Reinhard Windhager Jason Webb Nadine Zentgraf Klaus-Dieter Kuehn 

作者机构：Department of Orthopaedics and Orthopaedic SurgeryMedical University of Vienna Avon Orthopaedic CentreNorth Bristol NHS TrustSouthmead Hospital Heraeus Medical GmbH 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2017年第8卷第12期

页      面：881-890页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Polymethylmethacrylate Elution Fastsetting Viscosity Antibiotic Fatigue Arthroplasty 

摘      要：AIM To evaluate the behaviour of two fast-setting polymethylmethacrylate(PMMA) cements CMW~? 2 G and Palacos~? fast R + G, as reference: Standard-setting Palacos~? R + *** The fast-setting cements CMW~? 2 G and Palacos~? fast R + G were studied, using standard-setting high viscosity Palacos~? R + G as a reference. Eleven units(of two batch numbers) of each cement were tested. All cements were mixed as specified by the manufacturer and analysed on the following parameters: Handling properties(mixing, waiting, working and hardening phase) according to Kuehn, Mechanical properties according to ISO 5833 and DIN 53435, Fatigue strength according to ISO 16402, Benzoyl Peroxide(BPO)-Content by titration, powder/liquid-ratio by weighing, antibiotic elution profile by High Performance Liquid Chromatography. All tests were done in an acclimatised laboratory with temperatures set at 23.5 ℃± 0.5 ℃ and a humidity of 40%. RESULTS Palacos~? fast R + G showed slightly shorter handling properties(doughing, hardening phase, n = 12) than CMW~? 2 G, allowing to reduce operative time and to optimise cemented cup implantation. Data of the quasistatic properties of ISO 5833 and DIN 53435 of both cements tested was comparable. The ISO compressive strength(MPa) of Palacos~? fast R + G was significantly higher than CMW~? 2 G, resulting in ANOVA(P 0.01) and two sample t-test(P 0.01) at 0.05 level of significance(n = 20). Palacos~? fast R + G showed a higher fatigue strength of about 18% mean(ISO 16402) of 15.3 MPa instead of 13.0 MPa for CMW~? 2 G(n = 5 × 10~6 cycles). Palacos~? fast R + G and CMW~? 2 G differed only by 0.11%(n = 6) with the former having the higher content. The BPO-content of both cements were therefore comparable. CMW~? 2 G had a powder/liquid ratio of 2:1, Palacos~? fast R + G of 2.550:1 due to a higher powder content. Despite its higher gentamicin content, CMW~? 2 G showed a significantly lower antibiotic elution over time than Palacos~? fast R + G(n = 3). CON