The effect of standard and low-modulus cement augmentation on the stiffness, strength, and endplate pressure distribution in vertebroplasty

Vertebroplasty restores stiffness and strength of fractured vertebral bodies, but alters their stress transfer. This unwanted effect may be reduced by using more compliant cements. However, systematic experimental comparison of structural properties between standard and low-modulus augmentation needs to be done. This study investigated how standard and low-modulus cement augmentation affects apparent stiffness, strength, and endplate pressure distribution of vertebral body sections.

Adjacent vertebral failure after vertebroplasty: a biomechanical study of low-modulus PMMA cement

PMMA is the most common bone substitute used for vertebroplasty. An increased fracture rate of the adjacent vertebrae has been observed after vertebroplasty. Decreased failure strength has been noted in a laboratory study of augmented functional spine units (FSUs), where the adjacent, non-augmented vertebral body always failed. This may provide evidence that rigid cement augmentation may facilitate the subsequent collapse of the adjacent vertebrae. The purpose of this study was to evaluate whether the decrease in failure strength of augmented FSUs can be avoided using low-modulus PMMA bone cement. In cadaveric FSUs, overall stiffness, failure strength and stiffness of the two vertebral bodies were determined under compression for both the treated and untreated specimens. Augmentation was performed on the caudal vertebrae with either regular or low-modulus PMMA. Endplate and wedge-shaped fractures occurred in the cranial and caudal vertebrae in the ratios endplate:wedge (cranial:caudal): 3:8 (5:6), 4:7 (7:4) and 10:1 (10:1) for control, low-modulus and regular cement group, respectively. The mean failure strength was 3.3 +/- 1 MPa with low-modulus cement, 2.9 +/- 1.2 MPa with regular cement and 3.6 +/- 1.3 MPa for the control group. Differences between the groups were not significant (p = 0.754 and p = 0.375, respectively, for low-modulus cement vs. control and regular cement vs. control). Overall FSU stiffness was not significantly affected by augmentation. Significant differences were observed for the stiffness differences of the cranial to the caudal vertebral body for the regular PMMA group to the other groups (p < 0.003). The individual vertebral stiffness values clearly showed the stiffening effect of the regular cement and the lesser alteration of the stiffness of the augmented vertebrae using the low-modulus PMMA compared to the control group (p = 0.999). In vitro biomechanical study and biomechanical evaluation of the hypothesis state that the failure strength of augmented functional spine units could be better preserved using low-modulus PMMA in comparison to regular PMMA cement.

Properties of an injectable low modulus PMMA bone cement for osteoporotic bone

The use of polymethylmethacrylate (PMMA) cement to reinforce fragile or broken vertebral bodies (vertebroplasty) leads to extensive bone stiffening. Fractures in the adjacent vertebrae may be the consequence of this procedure. PMMA with a reduced Young's modulus may be more suitable. The goal of this study was to produce and characterize stiffness adapted PMMA bone cements. Porous PMMA bone cements were produced by combining PMMA with various volume fractions of an aqueous sodium hyaluronate solution. Porosity, Young's modulus, yield strength, polymerization temperature, setting time, viscosity, injectability, and monomer release of those porous cements were investigated. Samples presented pores with diameters in the range of 25-260 microm and porosity up to 56%. Young's modulus and yield strength decreased from 930 to 50 MPa and from 39 to 1.3 MPa between 0 and 56% porosity, respectively. The polymerization temperature decreased from 68 degrees C (0%, regular cement) to 41 degrees C for cement having 30% aqueous fraction. Setting time decreased from 1020 s (0%, regular cement) to 720 s for the 30% composition. Viscosity of the 30% composition (145 Pa s) was higher than the ones received from regular cement and the 45% composition (100-125 Pa s). The monomer release was in the range of 4-10 mg/mL for all porosities; showing no higher release for the porous materials. The generation of pores using an aqueous gel seems to be a promising method to make the PMMA cement more compliant and lower its mechanical properties to values close to those of cancellous bone.

Behaviour of Bi-adhesive Joints

The use of relatively low modulus adhesive at the ends of overlap in a bi-adhesive bondline of a bonded joint can reduce the stress concentration significantly and, therefore, potentially lead to higher strength of the joint. This study presents the two-dimensional and three-dimensional nonlinear (geometric and material) finite element analyses of adhesively bonded single lap joints having modulus-graded bondline under monotonic loading conditions. The adhesives were modelled as an elasto-plastic multi-linear material, while the substrates were regarded as both linear elastic and bi-linear elasto-plastic material. The computational simulations have been performed to investigate the bondline behaviour by studying the stress and strain distributions both at the mid-plane as well as at the interface of the bondline. It has been observed that the static strength is higher for joints with bi-adhesive bondlines compared to those with single adhesives in bondline. Higher joint strength has also been observed for optimum bi-adhesive bondline ratio through parametric studies. Effects of load level, and bondline thickness on stress distribution in the bi-adhesive bondline have also been studied. 3D analysis results reveal the existence of complex multi-axial stress/strain state at the ends of the overlap in the bondline which cannot be observed in 2D plane strain analysis. About 1/3rd of the width of the joint from the free edge in the width direction has 3D stress state, especially in the compliant adhesive of the bondline. Magnitudes of longitudinal and lateral stress/strain components are comparable to peel stress/strain components. It has also been analytically shown that the in-plane global stiffness of the joint remains unaffected by modulus gradation of the bondline adhesive. (C) Koninklijke Brill NV, Leiden, 2010.

Transverse cracking of a simple lap joint under axial load

The failure mode of axially loaded simple, single lap joints formed between thin adherends which are flexible in bending is conventionally described as one of axial peeling. We have observed - using high-speed photography - that it is also possible for failure to be preceded by the separation front, or crack, moving in a transverse direction, i.e. perpendicular to the direction of the axial load. A simple energy balance analysis suggests that the critical load for transverse failure is the same as that for axial separation for both flexible lap joints, where the bulk of the stored elastic energy lies in the adhesive, and structural lap joints in which the energy stored in the adherends dominates. The initiation of the failure is dependent on a local increases in either stress or strain energy to some critical values. In the case of a flexible joint, this will occur within the adhesive layer and the critical site will be close to one of the corners of the joint overlap from which the separation front can proceed either axially or transversely. These conclusions are supported by a finite element analysis of a joint formed between adherends of finite width by a low modulus adhesive. © 2012 Taylor & Francis.

Computer simulating a trial of a load-bearing implant: example of an intramedullary prosthesis

Computational modelling is becoming ever more important for obtaining regulatory approval for new medical devices. An accepted approach is to infer performance in a population from an analysis conducted for an idealised or ‘average’ patient; we present here a method for predicting the performance of an orthopaedic implant when released into a population—effectively simulating a clinical trial. Specifically we hypothesise that an analysis based on a method for predicting the performance in a population will lead to different conclusions than an analysis based on an idealised or ‘average’ patient. To test this hypothesis we use a finite element model of an intramedullary implant in a bone whose size and remodelling activity is different for each individual in the population. We compare the performance of a low Young’s modulus implant (View the MathML source) to one with a higher Young’s modulus (200 GPa). Cyclic loading is applied and failure is assumed when the migration of the implant relative to the bone exceeds a threshold magnitude. The analysis for an idealised of ‘average’ patient predicts that the lower modulus device survives longer whereas the analysis simulating a clinical trial predicts no statistically-significant tendency (p=0.77) for the low modulus device to perform better. It is concluded that population-based simulations of implant performance–simulating a clinical trial–present a very valuable opportunity for more realistic computational pre-clinical testing of medical devices.

Enhancement of Wear and Corrosion Resistance of Beta Titanium Alloy by Laser Gas Alloying with Nitrogen

The relatively high elastic modulus coupled with the presence of toxic vanadium (V) in Ti6Al4 V alloy has long been a concern in orthopaedic applications. To solve the problem, a variety of non-toxic and low modulus beta-titanium (beta-Ti) alloys have been developed. Among the beta-Ti alloy family, the quaternary Ti-Nb-Zr-Ta (TNZT) alloys have received the highest attention as a promising replacement for Ti6Al4 V due to their lower elastic modulus and outstanding long term stability against corrosion in biological environments. However, the inferior wear resistance of TNZT is still a problem that must be resolved before commercialising in the orthopaedic market. In this work, a newly-developed laser surface treatment technique was employed to improve the surface properties of Ti-35.3Nb-7.3Zr-5.7Ta alloy. The surface structure and composition of the laser-treated TNZT surface were examined by grazing incidence x-ray diffraction (GI-XRD) and x-ray photoelectron spectroscopy (XPS). The wear and corrosion resistance were evaluated by pin-on-plate sliding test and anodic polarisation test in Hanks’ solution. The experimental results were compared with the untreated (or base) TNZT material. The research findings showed that the laser surface treatment technique reported in this work can effectively improve the wear and corrosion resistance of TNZT.

Histomorphologic evaluation of Ti-13Nb-13Zr alloys processed via powder metallurgy. A study in rabbits

This study presents the in-vivo evaluation of Ti-13Nb-13Zr alloy implants obtained by the hydride route via powder metallurgy. The cylindrical implants were processed at different sintering and holding times. The implants` were characterized for density, microstructure (SEM), crystalline phases (XRD), and bulk (EDS) and surface composition (XPS). The implants were then sterilized and surgically placed in the central region of the rabbit`s tibiae. Two double fluorescent markers were applied at 2 and 3 weeks, and 6 and 7 weeks after implantation. After an 8-week healing period, the implants were retrieved, non-decalcified section processed, and evaluated by electron, UV light (fluorescent labeling), and light microscopy (toluidine blue). BSE-SEM showed close contact between bone and implants. Fluorescent labeling assessment showed high bone activity levels at regions close to the implant surface. Toluidine blue staining revealed regions comprising osteoblasts at regions of newly forming/formed bone close to the implant surface. The results obtained in this study support biocompatible and osseoconductive properties of Ti-13Nb-13Zr processed through the hydride powder route. (c) 2007 Published by Elsevier B.V.

Production of Ti-35Nb alloy by powder metallurgy for aerospace application

Titanium and its alloys provide high strength-to-weight ratios, good fatigue strength and increased corrosion resistance compared with others materials. Its acceptance in aerospace has been limited by costs considerations such as high cost of raw material, high buy-to-fly ratios and expensive machining operations. Significant cost reductions can be obtained by vacuum sintering and powder metallurgy (P/M) techniques by producing near net shapes and consequently minimizing material waste and machining time. The Ti 35Nb alloy exhibit a low modulus of elasticity. Stemming from the unique combination of high strength, low modulus of elasticity and low density, this alloy is intrinsically more resistant to shock and explosion damages than most other engineering materials. Samples were produced by mixing of initial metallic powders followed by uniaxial and cold isostatic pressing with subsequent densification by sintering between 900 and 1600 °C, in vacuum. Sintering behavior was studied by means of dilatometry. Sintered samples were characterized for phase composition, microstructure and microhardness by X-ray diffraction, scanning electron microscopy and Vickers indentation, respectively. Density was measured by Archimedes method. Copyright © 2004 Society of Automotive Engineers, Inc.

Influência da Qualidade das Lâminas no Desempenho Mecânico à Flexão de Painéis Compensados de Hevea brasiliensis

After concluding the main phase of commercial exploration of latex (about 30 years ago), rubber wood plantations can be utilized as an alternative source of wood for sawmills and other wood based products with more aggregate value; tendency already confirmed in countries of southeastern Asia. The main purpose of this research was to evaluate the influence of dynamic modulus of elasticity veneers on the mechanical performance in the bending of plywood made from Hevea brasiliensis. For this study, rubber tree veneers were sorted in three classes of dynamic modulus of elasticity: low (from 4887-7323 MPa), medium (from 8200-8948 MPa) and high (from 10979-13010 MPa). Panels were produced according to five treatments with different veneer classes and arrangements. Results showed significant effect of the treatments in the mechanical performance in the bending of panels. Panels with better mechanical performance were produced exclusively with medium and high dynamic modulus of elasticity. Panels made with low modulus of elasticity veneers presented lower mechanical performance even when combined with high modulus of elasticity veneers.

Influência da qualidade das lâminas no desempenho físico-mecânico de painéis compensados de Hevea brasiliensis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Desempenho físico-mecânico de painéis LVL de pinus tropicais da região de São Paulo

Pós-graduação em Agronomia (Energia na Agricultura) - FCA

Obtenção da liga Ti-35Nb por metalurgia do pó para utilização em próteses ortopédicas

Pós-graduação em Engenharia Mecânica - FEG

Efeito do oxigênio intersticial no módulo de elasticidade de Ligas Ti-15Mo-xZr(x=5,10,15%p)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito de elementos susbstitucionais e intersticiais nas propriedades mecânicas e na biocompatibilidade de ligas do sistema Ti-15Zr-xMo

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)