Fölsch Christian, Schirmer Julia, Glameanu Cosmin, Ishaque Bernd, Fonseca Ulloa Carlos Alfonso, Harz Torben, Rickert Markus, Martin John Ryan, Scherberich Jan, Steinbart Jessica, Krombach Gabriele, Paul Christian, Kühn Klaus-Dieter, Jahnke Alexander
Department of Orthopaedics and Orthopaedic Surgery, University Hospital Gießen and Marburg (UKGM), Justus-Liebig-University, Gießen, Germany.
Laboratory of Biomechanics, Justus-Liebig-University Gießen, Gießen, Germany.
Arthroplast Today. 2024 Oct 17;30:101476. doi: 10.1016/j.artd.2024.101476. eCollection 2024 Dec.
Application time and viscosity are factors that can significantly affect the properties of bone cement and implant fixation. The aim of this study was to investigate the influence of different application times of 2 different cements on mechanical parameters, cement interdigitation, and cement distribution.
P.F.C. Sigma tibial trays were cemented with high-viscous Palacos R and medium- to low-viscous Simplex P in an open-cell model. The application was performed at different times within the manufacturer's specifications. Cement interdigitation and micromotion were measured with computed tomography scan using a novel method.
Significant differences of insertion forces were found at all times of cement application. Cement penetration decreased with increasing pressure and viscosity. No significant differences were shown for micromotion between Palacos R and Simplex P except for an increase for Simplex P from 3 to 7 minutes at the bone-cement interface. Simplex P appeared to trap air at the implant-cement interface at 3 minutes and increased at 7 minutes.
Cement distribution and intrusion of Palacos R and Simplex P decreased with time. Simplex P trapped air at the implant-cement interface, decreasing the amount of contact at the implant-cement interface, which is worrisome for long-term implant fixation. Given the significant changes in cement properties after mixing, it is necessary for surgeons to understand the viscosity and timing of cement application to achieve optimal cement penetration and surface contact area to potentially decrease implant loosening. High-viscous Palacos R should be applicated immediately with doughing time and medium-viscous Simplex P for about 4 minutes considering a threshold of minimum pressure.
应用时间和粘度是可显著影响骨水泥性能及植入物固定的因素。本研究的目的是调查两种不同骨水泥的不同应用时间对力学参数、骨水泥相互交锁及骨水泥分布的影响。
在开放孔模型中，使用高粘度的帕拉科斯R骨水泥和中低粘度的辛普利斯P骨水泥固定P.F.C.西格玛胫骨托。应用在制造商规定的不同时间内进行。采用一种新方法通过计算机断层扫描测量骨水泥相互交锁和微动。
在骨水泥应用的所有时间点均发现插入力存在显著差异。骨水泥渗透随压力和粘度增加而降低。除了在骨-骨水泥界面处辛普利斯P从3分钟到7分钟有增加外，帕拉科斯R和辛普利斯P之间的微动无显著差异。辛普利斯P在3分钟时似乎在植入物-骨水泥界面处困住空气，在7分钟时增加。
帕拉科斯R和辛普利斯P的骨水泥分布和侵入随时间减少。辛普利斯P在植入物-骨水泥界面处困住空气，减少了植入物-骨水泥界面处的接触量，这对长期植入物固定令人担忧。鉴于混合后骨水泥性能的显著变化，外科医生有必要了解骨水泥应用时的粘度和时间，以实现最佳的骨水泥渗透和表面接触面积，从而可能减少植入物松动。考虑到最小压力阈值，高粘度的帕拉科斯R应在面团期立即应用，中粘度的辛普利斯P应用约4分钟。
