Nottrott Markus, Mølster Anders Odd, Gjerdet Nils Roar
Department of Orthopaedic Surgery, Haukeland University Hospital, 5021 Bergen, Norway.
J Biomed Mater Res B Appl Biomater. 2007 Nov;83(2):416-21. doi: 10.1002/jbm.b.30811.
Changes in mechanical properties of bone cements over time are of clinical importance, but not well documented. Specifications for testing do not address the time factor. This study recorded changes in compressive properties and microstructure of one bone cement stored under simulated physiological conditions (water at 37 degrees C) from 20 min up to 1 year and in dry air at 37 degrees C for comparison. Compressive strength increased within the first week (p < 0.001), decreased at 1 month (p < 0.001), and remained at that level at 1 year. Elastic modulus showed a similar development. Maximum strain values, indicating plastic deformability, increased continuously over 1 year. Microscopy revealed microcracks between the pre-polymer beads and the matrix in specimens tested after 20 min, whereas there were less cracks in 1 year specimens. Increase in strength during the first week is due to polymerization and formation of interpenetrating molecular networks. The subsequent decrease could be due to the plasticizing effect of water uptake, as supported by higher values for dry specimens. It can be speculated that microcracks which could be initiated while reducing an arthroplasty at 15 min, acting as initiators for fatigue fractures in the cement mantle, contribute to cement failure. It is recommended that testing of bone cements should be performed after extended ageing at simulated physiological conditions, for the present cement at least 5 weeks. Results obtained at less than one week could be influenced by ongoing polymerization, as well as microcracks and lower coherence between the prepolymer beads and the matrix.
骨水泥力学性能随时间的变化具有临床重要性,但相关记录并不完善。测试规范未涉及时间因素。本研究记录了一种骨水泥在模拟生理条件(37℃水)下从20分钟至1年的抗压性能和微观结构变化,并与在37℃干燥空气中保存的情况进行比较。抗压强度在第一周内增加(p<0.001),在1个月时下降(p<0.001),并在1年时维持在该水平。弹性模量呈现类似的变化趋势。表明塑性变形能力的最大应变值在1年中持续增加。显微镜检查显示,在测试20分钟后的标本中,预聚物珠粒与基质之间存在微裂纹,而1年标本中的裂纹较少。第一周强度增加是由于聚合作用和互穿分子网络的形成。随后的下降可能是由于吸水的增塑作用,干燥标本的较高值支持了这一点。可以推测,在15分钟时减少关节置换术时可能引发的微裂纹,作为水泥套疲劳骨折的引发因素,会导致水泥失效。建议在模拟生理条件下长时间老化后对骨水泥进行测试,对于目前的骨水泥至少5周。在不到一周时获得的结果可能会受到持续聚合、微裂纹以及预聚物珠粒与基质之间较低内聚力的影响。