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

World Journal of Orthopedics 2017年第12期8卷 881-890页

作者： neil ayron caraan Reinhard Windhager Jason Webb Nadine Zentgraf Klaus-Dieter Kuehn Department of Orthopaedics and Orthopaedic Surgery Medical University of Vienna Avon Orthopaedic Centre North Bristol NHS TrustSouthmead Hospital Heraeus Medical GmbH

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

关键词： Polymethylmethacrylate Elution Fastsetting Viscosity Antibiotic Fatigue Arthroplasty

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