Shear properties of bilaminar polymethylmethacrylate cement mantles in revision hip joint arthroplasty.
Although cement-within-cement revision arthroplasty minimizes the complications associated with removal of secure PMMA, failure at the interfacial region between new and old cement mantles remains a theoretical concern. This article assesses the variability in shear properties of bilaminar cement mantles related to duration of postcure and the use of antibiotic cements. Bilaminar cement mantles were 15% to 20% weaker than uniform mantles (P < .001) and demonstrated variability in shear strength related to duration of postcure of the freshly applied cement (P < .001). The use of Antibiotic Simplex did not significantly influence interfacial cement adhesion (P = .52). Interfacial adhesion by mechanisms other than mechanical interlock plays a significant role in the bond formed between new and old PMMA cements, with an important contribution by diffusion-based molecular interdigitation. In the presence of a secure cement-bone interface, we recommend cement-within-cement revision techniques in suitable patients.
Weinrauch
Patrick C
PC
School of Engineering Systems, Queensland University of Technology, Brisbane, Australia.
Bell
Cameron
C
Wilson
Lance
L
Goss
Ben
B
Lutton
Cameron
C
Crawford
Ross W
RW
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements / Q000494:pharmacology*; D002484:Cementation; D020342:Finite Element Analysis; D006801:Humans; D008422:Materials Testing; D019904:Polymethyl Methacrylate / Q000494:pharmacology*; D012086:Reoperation; D014031:Tobramycin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D001843:Bone Cements; D019904:Polymethyl Methacrylate; D014031:Tobramycin