title: Bone marrow modified acrylic bone cement for augmentation of osteoporotic cancellous bone.
abstract: The use of polymethylmethacrylate (PMMA) cement to reinforce fragile or broken vertebral bodies (vertebroplasty) leads to extensive bone stiffening. This might be one reason for fractures at the adjacent vertebrae following this procedure. PMMA with a reduced Young's modulus may be more suitable. The goal of this study was to produce and characterize PMMA bone cements with a reduced Young's modulus by adding bone marrow. Bone cements were produced by combining PMMA with various volume fractions of freshly harvested bone marrow from sheep. Porosity, Young's modulus, yield strength, polymerization temperature, setting time and cement viscosity of different cement modifications were investigated. The samples generated comprised pores with diameters in the range of 30-250 μm leading to porosity up to 51%. Compared to the control cement, Young's modulus and yield strength decreased from 1830 to 740 MPa and from 58 to 23 MPa respectively by adding 7.5 ml bone marrow to 23 ml premixed cement. The polymerization temperature decreased from 61 to 38 ∘C for cement modification with 7.5 ml of bone marrow. Setting times of the modified cements were lower in comparison to the regular cement (28 min). Setting times increased with higher amounts of added bone marrow from around 16-25 min. The initial viscosities of the modified cements were higher in comparison to the control cement leading to a lower risk of extravasation. The hardening times followed the same trend as the setting times. In conclusion, blending bone marrow with acrylic bone cement seems to be a promising method to increase the compliance of PMMA cement for use in cancellous bone augmentation in osteoporotic patients due to its modified mechanical properties, lower polymerization temperature and elevated initial viscosity.
authors.affiliation: AO Research Institute, Clavadelerstrasse 8, 7270 Davos Platz, Switzerland. daniel.arens@aofoundation.org
authors.forename: Daniel
authors.initials: D
authors.lastname: Arens
authors.forename: Stephan
authors.initials: S
authors.lastname: Rothstock
authors.forename: Markus
authors.initials: M
authors.lastname: Windolf
authors.forename: Andreas
authors.initials: A
authors.lastname: Boger
mesh_terms: D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry / Q000378:metabolism*; D001853:Bone Marrow / Q000378:metabolism*; D001842:Bone and Bones / Q000601:surgery*; D003187:Compliance; D005260:Female; D010024:Osteoporosis / Q000601:surgery*; D058105:Polymerization; D019904:Polymethyl Methacrylate / Q000737:chemistry / Q000378:metabolism*; D016062:Porosity; D012756:Sheep; D013696:Temperature; D013997:Time Factors; D054854:Vertebroplasty / Q000379:methods*; D014783:Viscosity
chemical_list: D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate