Micromechanical characterisation of failure in acrylic bone cement: the effect of barium sulphate agglomerates.

Acrylic bone cement has been established as a method of fixation of load-bearing orthopaedic implants for nearly five decades, and has produced excellent long term clinical results. However, increasing patient BMI values and longer life expectancies are placing ever greater demands on joint replacements, so there is a need to further improve the performance of cemented fixation. Damage accumulation in the in vivo cement mantle due to initiation and coalescence of fatigue micro-cracks has been implicated in the aseptic loosening and failure of implants. While the effect of porosity on crack initiation processes has been widely reported, the relative influence of different radiopacifying agents is less well studied. In particular, barium sulphate radiopacifier particles have been reported to form large agglomerates within the cement that have been linked to initiation of fatigue cracks in vitro. However, there appears to be little understanding of the micromechanical aspects of cement failure due to barium sulphate agglomeration. The present study utilised micro-computed tomography (μCT) and field emission gun scanning electron microscopy (FEG-SEM), alongside mechanical testing, to provide a systematic, quantitative assessment of the effect of barium sulphate agglomeration on crack initiation processes in a conventional, vacuum-mixed acrylic cement. Three-dimensional characterisation of defect populations was performed, with agglomerates of barium sulphate particles found to be large (up to 0.37 mm equivalent spherical diameter), present at spatial densities up to 22 per mm³, and evenly distributed through each cement specimen. Fatigue cracks consistently initiated at the largest agglomerates; furthermore, fatigue life was found to scale consistently with largest defect size. As such, the tendency of barium sulphate particles to agglomerate is clearly evidenced to be detrimental to the fatigue performance of this cement in vitro. Optimisation of mixing techniques and/or cement formulations containing barium sulphate may therefore be advantageous to reduce the formation of agglomerates and their potential effects in vivo.