title: Biomechanical behavior of novel composite PMMA-CaP bone cements in an anatomically accurate cadaveric vertebroplasty model.
abstract: Vertebral compression fractures are caused by many factors including trauma and osteoporosis. Osteoporosis induced fractures are a result of loss in bone mass and quality that weaken the vertebral body. Vertebroplasty and kyphoplasty, involving cement augmentation of fractured vertebrae, show promise in restoring vertebral mechanical properties. Some complications however, are reported due to the performance characteristics of commercially available bone cements. In this study, the biomechanical performance characteristics of two novel composite (PMMA-CaP) bone cements were studied using an anatomically accurate human cadaveric vertebroplasty model. The study involves mechanical testing on two functional cadaveric spinal unit (2FSU) segments which include monotonic compression and cyclical fatigue tests, treatment by direct cement injection, and microscopic visualization of sectioned vertebrae. The 2FSU segments were fractured, treated, and mechanically tested to investigate the stability provided by two novel bone cements; using readily available commercial acrylic cement as a control. Segment height and stiffness were tracked during the study to establish biomechanical performance. The 2FSU segments were successfully stabilized with all three cement groups. Stiffness values were restored to initial levels following fatigue loading. Cement interdigitation was observed with all cement groups. This study demonstrates efficient reinforcement of the fractured vertebrae through stiffness restoration. The pre-mixed composite cements were comparable to the commercial cement in their performance and interdigitative ability, thus holding promise for future clinical use. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2067-2074, 2017.
authors.affiliation: Biomaterials for Osseointegration and Novel Engineering Laboratory (BONE Lab), Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, 75080.
authors.forename: Shant
authors.initials: S
authors.lastname: Aghyarian
authors.affiliation: Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Plano Hospital, Plano, Texas, 75093.
authors.forename: Xiaobang
authors.initials: X
authors.lastname: Hu
authors.affiliation: Texas Back Institute Research Foundation, Plano, Texas, 75093.
authors.forename: Ram
authors.initials: R
authors.lastname: Haddas
authors.affiliation: Scoliosis and Spine Tumor Center, Texas Back Institute, Texas Health Plano Hospital, Plano, Texas, 75093.
authors.forename: Isador H
authors.initials: IH
authors.lastname: Lieberman
authors.affiliation: Department of Orthopaedic Surgery, University of North Texas Health Science Center (UNTHSC), Fort Worth, Texas, 76107.|Department of Materials Science and Engineering, University of North Texas, Denton, Texas, 76203.
authors.forename: Victor
authors.initials: V
authors.lastname: Kosmopoulos
authors.affiliation: Center of Excellence in Hip Disorders, Texas Scottish Rite Hospital for Children, 2222 Welborn Street, Dallas, Texas, 75219.|Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, Texas, 75390.
authors.forename: Harry K W
authors.initials: HKW
authors.lastname: Kim
authors.affiliation: Biomaterials for Osseointegration and Novel Engineering Laboratory (BONE Lab), Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, 75080.
authors.forename: Danieli C
authors.initials: DC
authors.lastname: Rodrigues
mesh_terms: D000369:Aged, 80 and over; D001843:Bone Cements; D002130:Calcium Phosphates; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D019904:Polymethyl Methacrylate; D054854:Vertebroplasty
chemical_list: D001843:Bone Cements; D002130:Calcium Phosphates; D019904:Polymethyl Methacrylate; C020243:calcium phosphate
keywords: bone cement; calcium phosphate; vertebral compression fractures; vertebroplasty