Effect of ternary phosphate-based glass compositions on osteoblast and osteoblast-like prolferation, differentiation and death in vitro

There is currently a need to expand the range of graft materials available to orthopaedic surgeons. This study investigated the effect of ternary phosphate based glass (PBG) compositions on the behaviour of osteoblast and osteoblast-like cells. PBGs of the formula in mol% P2O5 (50)-CaO (50-X)-Na2O (X), where X was either 2, 4, 6, 8 or 10 were produced and their influence on the proliferation, differentiation and death in vitro of adult human bone marrow stromal cells (hBMSCs) and human fetal osteoblast 1.19 (HFOB 1.19) cells were assessed. Tissue culture plastic (TCP) and hydroxyapatite (HA) were used as controls. Exposure to PBGs in culture inhibited cell adhesion, proliferation and increased cell death in both cell types studied. There was no significant difference in %cell death between the PBGs which was significantly greater than the controls. However, compared to other PBGs, a greater number of cells was found on the 48 mol% CaO which may have been due to either increased adherence, proliferation or both. This composition was capable of supporting osteogenic proliferation and early differentiation and supports the notion that chemical modification of the glass could to lead to a more biologically compatible substrate with the potential to support osteogenic grafting. Realisation of this potential should lead to the development of novel grafting strategies for the treatment of problematic bone defects.

Factorial Design of Cement Slurries Containing Limestone Powder for Self-Consolidating Slurry-Infiltrated Fiber Concrete

Slurries with high penetrability for production of Self-consolidating Slurry Infiltrated Fiber Concrete (SIFCON) were investigated in this study. Factorial experimental design was adopted in this investigation to assess the combined effects of five independent variables on mini-slump test, plate cohesion meter, induced bleeding test, J-fiber penetration test and compressive strength at 7 and 28 days. The independent variables investigated were the proportions of limestone powder (LSP) and sand, the dosages of superplasticiser (SP) and viscosity agent (VA), and water-to-binder ratio (w/b). A two-level fractional factorial statistical method was used to model the influence of key parameters on properties affecting the behaviour of fresh cement slurry and compressive strength. The models are valid for mixes with 10 to 50% LSP as replacement of cement, 0.02 to 0.06% VA by mass of cement, 0.6 to 1.2% SP and 50 to 150% sand (% mass of binder) and 0.42 to 0.48 w/b. The influences of LSP, SP, VA, sand and W/B were characterised and analysed using polynomial regression which identifies the primary factors and their interactions on the measured properties. Mathematical polynomials were developed for mini-slump, plate cohesion meter, J-fiber penetration test, induced bleeding and compressive strength as functions of LSP, SP, VA, sand and w/b. The estimated results of mini-slump, induced bleeding test and compressive strength from the derived models are compared with results obtained from previously proposed models that were developed for cement paste. The proposed response models of the self-consolidating SIFCON offer useful information regarding the mix optimization to secure a highly penetration of slurry with low compressive strength

Influence of mix proprtions on rheolgy of cement grouts containing limestone powder

In this paper the parameters of cement grout affecting rheological behaviour and compressive strength are investigated. Factorial experimental design was adopted in this investigation to assess the combined effects of the following factors on fluidity, rheological properties, induced bleeding and compressive strength: water/binder ratio (W/B), dosage of superplasticiser (SP), dosage of viscosity agent (VA), and proportion of limestone powder as replacement of cement (LSP). Mini-slump test, Marsh cone, Lombardi plate cohesion meter, induced bleeding test, coaxial rotating cylinder viscometer were used to evaluate the rheology of the cement grout and the compressive strengths at 7 and 28 days were measured. A two-level fractional factorial statistical model was used to model the influence of key parameters on properties affecting the fluidity, the rheology and compressive strength. The models are valid for mixes with 0.35-0.42 W/B, 0.3-1.2% SP, 0.02-0.7% VA (percentage of binder) and 12-45% LSP as replacement of cement. The influences of W/B, SP, VA and LSP were characterised and analysed using polynomial regression which can identify the primary factors and their interactions on the measured properties. Mathematical polynomials were developed for mini-slump, plate cohesion meter, inducing bleeding, yield value, plastic viscosity and compressive strength as function of W/B, SP, VA and proportion of LSP. The statistical approach used highlighted the limestone powder effect and the dosage of SP and VA on the various rheological characteristics of cement grout

A geotechnical description of fresh cement grout - filtration and consolidation behaviour

The removal of water from three Portland cement grouts by pressure filtration is examined, and the consolidation behaviour of the filtered material clarified. The filtration takes place by the laying down of a very stiff filter cake through the removal of excess water. The behaviour due to further loading resembles that of a re-constituted silt. For stress levels above the filtration pressure the calculated permeability values are similar to those from the filtration phase only if the data sampling rate was sufficiently rapid to discriminate the first portion of the observed primary consolidation curve. The change in void ratio for incremental loading is roughly linear with the change in the logarithm of the vertical effective stress. The characterisation of fresh cement paste using standard soil mechanics models is both appropriate and useful, at least during the first few hours after mixing.

Incorporation of chitosan in acrylic bone cement: Effect on antibiotic release, bacterial biofilm formation and mechanical properties

Bacterial infection remains a significant problem following total joint replacement. Efforts to prevent recurrent implant infection, including the use of antibiotic-loaded bone cement for implant fixation at the time of revision surgery, are not always successful. In this in vitro study, we investigated whether the addition of chitosan to gentamicin-loaded Palacos® R bone cement increased antibiotic release and prevented bacterial adherence and biofilm formation by Staphylococcus spp. clinical isolates. Furthermore, mechanical tests were performed as a function of time post-polymerisation in pseudo-physiological conditions. The addition of chitosan to gentamicin-loaded Palacos® R bone cement significantly decreased gentamicin release and did not increase the efficacy of the bone cement at preventing bacterial colonisation and biofilm formation. Moreover, the mechanical performance of cement containing chitosan was significantly reduced after 28 days of saline degradation with the compressive and bending strengths not in compliance with the minimum requirements as stipulated by the ISO standard for PMMA bone cement. Therefore, incorporating chitosan into gentamicin-loaded Palacos® R bone cement for use in revision surgery has no clinical antimicrobial benefit and the detrimental effect on mechanical properties could adversely affect the longevity of the prosthetic joint.

In vitro study of the efficacy of acrylic bone cement loaded with supplementary amounts of gentamicin: Effect on mechanical properties, antibiotic release, and biofilm formation

Background: Infection remains a severe complication following a total hip replacement. If infection is suspected when revision surgery is being performed, additional gentamicin is often added to the cement on an ad hoc basis in an attempt to reduce the risk of recurrent infection.

Methods and results: In this in vitro study, we determined the effect of incorporating additional gentamicin on the mechanical properties of cement. We also determined the degree of gentamicin release from cement, and also the extent to which biofilms of clinical Staphylococcus spp. isolates form on cement in vitro. When gentamicin was added to unloaded cement (1–4 g), there was a significant reduction in the mechanical performance of the loaded cements compared to unloaded cement. A significant increase in gentamicin release from the cement over 72 h was apparent, with the amount of gentamicin released increasing significantly with each additional 1 g of gentamicin added. When overt infection was modeled, the incorporation of additional gentamicin did result in an initial reduction in bacterial colonization, but this beneficial effect was no longer apparent by 72 h, with the clinical strains forming biofilms on the cements despite the release of high levels of gentamicin.

Interpretation: Our findings indicate that the addition of large amounts of gentamicin to cement is unlikely to eradicate bacteria present as a result of an overt infection of an existing implant, and could result in failure of the prosthetic joint because of a reduction in mechanical performance of the bone cement.