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Methyl methacrylate (MMA) is the basic component of bone cements. To use it, a dough is prepared from the liquid and powder by mixing right before application, which is normally done by the operating team. During its working phase the dough is then inserted into the tissue where polymerization is completed. Thus, the final implant polymethyl methacrylate (PMMA) is only created at the implantation site. Besides methyl methacrylate, bone cements sometimes contain other methacrylates, such as butyl methacrylate. To achieve X-ray opacity, radiopacifiers (zirconium dioxide or barium sulfate) are added to the powder. Both the liquid and powder components contain additives (initiator and activator) that launch polymerization and control the set ting when mixed together. Moreover, softener and emulsifiers are some times used. The addition of antibiotics to the powder component in order to prevent or treat infections has become especially important. Commercial bone cements differ in composition and the course of curing. Some are designed for high and others for low viscosity. The way the user handles and applies the cement always crucially influences the quality of the implant. This is why clear and comprehensive information about the cements should be available to show the user how all the relevant factors work It should also be possible together and how they depend on each other.
With an increasing number of bone cements available, it is vital that the correct material is selected for specific clinical procedures. A review of the most recent research in this field, this book covers such topics as hip replacements, verteboplasty and wear particles and osteolysis. It reviews materials and types of cement such as acrylic, polymethylmethacrylate and calcium phosphate cements and address the mechanical properties of bone cements such as fracture toughness and dynamic creep. The book closes with an examination of methods to enhance the properties of bone cements such as antibiotic loaded bone cements and bioactive cements.
Cemented Total Hip Arthroplasty (THA) remains one of the most successful procedures in Orthopaedic surgery. It has become very clear that it is the surgical expertise, in particular the quality of the cementing technique, which will affect long-term outcome and success. It is the intention of this book to provide an up-to-date comprehensive assessment of the entire field of cemented THA. Special emphasis has been given to practice-relevant aspects: well-illustrated and detailed operative steps as a practical guideline, a basic science chapter and long-term outcome data are provided. Minimally invasive surgery, modern perioperative management and patient fast tracking are covered. A number of highly respected experts have contributed to this in-depth compilation of the "state of the art" in 2005. This book is written and intended for both, trainees and established arthroplasty surgeons who are dedicated to perform a well-cemented THA.
G. H. I. M. WALENKAMP, D. W. MURRAY Since the first use of bone cement, there has been much discussion about this important tool in arthroplasty. Many authors consider the cemented prosthesis as the gold standard when evaluating the outcome of primary prostheses. In a large number of total hip arthroplasties, as registered in the Scandi navian Hip Registers, important differences in revision risks have been docu mented between hospitals. These differences are partly due to the use of di verse cement techniques. In the analysis of data, the influence of these tech niques, as well as the different cement types, is clear. A recent disaster with a newly developed cement also illustrated that the quality of the cement must be assured, and that the introduction of a new material must be carefully prepared and followed-up. The new Palamed cement has been developed by the makers of the well known Palacos and Refobacin Palacos, which appeared to be the best ce ments in the Swedish register. An improvement was noted in slightly better handling characteristics, but the end product is the same as Palacos. As men tioned, this cement will be carefully followed-up in the near future. However, its introduction is a good reason to gather the expertise of some of the lead ing figures in the field in this book. II History of Bone Cements CHAPTER 2. 1 Industrial Development of Bone Cement Twenty-Five Years of Experience w. EGE, K. D.
The third edition of Joint Replacement Technology provides a thoroughly updated review of recent developments in joint replacement technology. Joint replacement is a standard treatment for joint degradation and has improved the quality of life of millions of patients. Collaboration between clinicians and researchers is critical to its continued success and to meet the rising expectations of patients and surgeons.This edition covers a range of updated and new content, ranging from chapters on materials analysis and selection, to methodologies and techniques used for joint replacement and clinical challenges of replacing specific joints. Key topics include tribological considerations and experiments; challenges in joint bearing surfaces; cementless fixation techniques; healing responses to implants. Clinical challenges and perspectives are covered with the aid of case studies.Thanks to its widespread collaboration and international contributors, Joint Replacement Technology, Third Edition is useful for materials scientists and engineers in both academia and the biomedical industry. Chemists, clinicians, and other researchers in this area will also find this text invaluable. - This third edition provides an updated comprehensive review of recent developments in joint replacement technology - Reviews a range of specific joints, biological and mechanical issues and fixation techniques - Includes revised and new content, such as sections on regulatory affairs, AI techniques and 3D printing
New technologies, developments in implant design and advances in surgical technique have improved outcomes after joint replacement and decreased rate of complications. It is not a surprise that the number of arthroplasties increases steadily every year and nowadays more than one million patients undergo the procedure annually worldwide. This book is a sequel of a successful series dedicated to one of the fastest growing fields in orthopedics - arthroplasty. Aiming at dissemination of scientific research this book provides a profound overview of the recent evolution of technology and surgical techniques. New developments of implant design and current treatment strategies have been critically discussed by the contributing authors. The process of improving care for patients and standards of treatment requires straightforward access to up-to-date research and knowledge. The format of the publication allows easy and quick reference to shared ideas and concepts. We hope, that the current book will add significant contribution to the success of this endeavor.
Bone Repair Biomaterials: Regeneration and Clinical Applications, Second Edition, provides comprehensive reviews on materials science, engineering principles and recent advances. Sections review the fundamentals of bone repair and regeneration, discuss the science and properties of biomaterials used for bone repair, including metals, ceramics, polymers and composites, and discuss clinical applications and considerations, with chapters on such topics as orthopedic surgery, tissue engineering, implant retrieval, and ethics of bone repair biomaterials. This second edition includes more chapters on relevant biomaterials and a greatly expanded section on clinical applications, including bone repair applications in dental surgery, spinal surgery, and maxilo-facial and skull surgery. In addition, the book features coverage of long-term performance and failure of orthopedic devices. It will be an invaluable resource for researchers, scientists and clinicians concerned with the repair and restoration of bone. - Provides a comprehensive review of the materials science, engineering principles and recent advances in this important area - Presents new chapters on Surface coating of titanium, using bone repair materials in dental, spinal and maxilo-facial and skull surgery, and advanced manufacturing/3D printing - Reviews the fundamentals of bone repair and regeneration, addressing social, economic and clinical challenges - Examines the properties of biomaterials used for bone repair, with specific chapters assessing metals, ceramics, polymers and composites
This handbook describes several current trends in the development of bioceramics and biocomposites for clinical use in the repair, remodelling, and regeneration of bone tissue. Comprehensive coverage of these materials allows fundamental aspects of the science and engineering to be seen in close relation to the clinical performance of dental and orthopaedic implants. Bioceramics and biocomposites appear to be the most dynamic area of materials development for both tissue engineering and implantable medical devices. Almost all medical specialties will continue to benefit from these developments, but especially dentistry and orthopaedics. In this Handbook, leading researchers describe the use of bionanomaterials to create new functionalities when interfaced with biological molecules or structures. Also described are technologies for bioceramics and biocomposites processing in order to fabricate medical devices for clinical use. Another important section of the book is dedicated to tissue regeneration with development of new matrices. A targeted or personalized treatment device reduces drug consumption and treatment expenses, resulting in benefits to the patient and cost reductions for public health systems. This authoritative reference on the state-of-the-art in the development and use of bioceramics and biocomposites can also serve as the basis of instructional course lectures for audiences ranging from advanced undergraduate students to post-graduates in materials science and engineering and biomedical engineering.
Bioceramics have been used very successfully within the human body for many years. They are commonly used in orthopaedic surgery and dentistry but they are potentially suitable for a wide range of important applications within the medical device industry. This important book reviews the range of bioceramics, their properties and range of clinical uses.Chapters in the first section of the book discusses issues of significance to a range of bioceramics such as their structure, mechanical properties and biological interactions. The second part reviews the fabrication, microstructure and properties of specific bioceramics and glasses, concentrating on the most promising materials. These include alumina and zirconia ceramics, bioactive glasses and bioactive glass-ceramics, calcium sulphate, tricalcium phosphate-based ceramics, hydroxyapatite, tricalcium phosphate/hydroxyapatite biphasic ceramics, si-substrated hydroxyapatite, calcium phosphate cement, calcium phosphate coating, titania-based materials, ceramic-polymer composites, dental ceramics and dental glass-ceramics. The final group of chapters reviews the clinical applications of bioceramics in joint replacement, bone grafts, tissue engineering and dentistry.Bioceramics and their clinical applications is written by leading academics from around the world and it provides an authoritative review of this highly active area of research. This book is a useful resource for biomaterials scientists and engineers, as well as for clinicians and the academic community. - Provides an authoritative review of this highly active area of research - Discusses issues of significance of a range of bioceramics such as their structure, mechanical properties and biological interactions - Reviews the clinical applications of bioceramics in joint replacement, bone grafts, tissue engineering and dentistry