Cecilia Persson

Biological and Biomechanical Effects of Vancomycin and Meropenem in Acrylic Bone Cement

Antibiotic-loaded bone cement is extensively used in joint arthroplasty, but increasing bacteria resistance against common antibiotics has lead to a demand for alternative drugs. However, bone cement containing new additives must be characterized both biologically and mechanically. This study evaluated elution kinetics, antibacterial activity, and mechanical properties for cement loaded with vancomycin and/or meropenem. The presence of meropenem broadened the antibacterial spectrum and enhanced the elution of vancomycin. The mechanical properties were negatively affected by 1.0 g of vancomycin, but these detrimental effects were acceptable when only 0.5 g of vancomycin were added to a cement containing 0.5 g of meropenem. Further investigations on this formulation with adjusted antibiotic amounts are, however, necessary to reach the optimal compromise between the antibacterial and the mechanical properties of the bone cement.

Mechanical effects of the use of vancomycin and meropenem in acrylic bone cement

Background The increasing resistance of certain bacteria to antibiotics commonly used in bone cements has led to a demand for alternative antibacterial agents. The antibiotics added to bone cements may, however, have detrimental effects on the mechanical properties of the cement. Material and methods We evaluated the mechanical effects of adding vancomycin and meropenem to bone cement by compression, bending and fatigue tests. Results Addition of vancomycin at a concentration of up to 2.5% (w/w) had no effect on the compressive strength. Bending and fatigue strength were negatively affected by vancomycin but not by meropenem. Interpretation A cement containing 1.25% vancomycin and 1.25% meropenem might be an interesting compromise between the introduction of antibacterial properties and preservation of the mechanical properties. With this concentration of additives the compressive strength and the fatigue strength remain unchanged, while the bending strength (–14%) and the bending modulus (–9%) are only slightly reduced and remain above the limits set by the ISO5833 standard.

Evaluation of silicon nitride as a wear resistant and resorbable alternative for total hip joint replacement

Many of the failures of total joint replacements are related to tribology, i.e., wear of the cup, head and liner. Accumulation of wear particles at the implants can be linked to osteolysis which leads to bone loss and in the end aseptic implant loosening. Therefore it is highly desirable to reduce the generation of wear particles from the implant surfaces. Silicon nitride (Si3N4) has shown to be biocompatible and have a low wear rate when sliding against itself and is therefore a good candidate as a hip joint material. Furthermore, wear particles of Si3N4 are predicted to slowly dissolve in polar liquids and they therefore have the potential to be resorbed in vivo, potentially reducing the risk for aseptic loosening. In this study, it was shown that α-Si3N4-powder dissolves in PBS. Adsorption of blood plasma indicated a good acceptance of Si3N4 in the body with relatively low immune response. Si3N4 sliding against Si3N4 showed low wear rates both in bovine serum and PBS compared with the other tested wear couples. Tribofilms were built up on the Si3N4 surfaces both in PBS and in bovine serum, controlling the friction and wear characteristics.

Robocasting of biomimetic hydroxyapatite scaffolds using self-setting inks

Low temperature self-setting ceramic inks have been scarcely investigated for solid freeform fabrication processes. This work deals with the robocasting of alpha-tricalcium phosphate/gelatine reactive slurries as a bioinspired self-setting ink for the production of biomimetic hydroxyapatite/gelatine scaffolds. A controlled and totally interconnected pore network of ∼300 μm was obtained after ink printing and setting, with the struts consisting of a micro/nanoporous matrix of needle-shaped calcium deficient hydroxyapatite crystals, with a high specific surface area. Gelatine was effectively retained by chemical crosslinking. The setting reaction of the ink resulted in a significant increase of both the elastic modulus and the compressive strength of the scaffolds, which were within the range of the human trabecular bone. In addition to delaying the onset of the setting reaction, thus providing enough time for printing, gelatine provided the viscoelastic properties to the strands to support their own weight, and additionally enhanced mesenchymal stem cell adhesion and proliferation on the surface of the scaffold. Altogether this new processing approach opens good perspectives for the design of hydroxyapatite scaffolds for bone tissue engineering with enhanced reactivity and resorption rate.

The Importance of Fluid-Structure Interaction in Spinal Trauma Models

While recent studies have demonstrated the importance of the initial mechanical insult in the severity of spinal cord injury, there is a lack of information on the detailed cord-column interaction during such events. In vitro models have demonstrated the protective properties of the cerebrospinal fluid, but visualization of the impact is difficult. In this study a computational model was developed in order to clarify the role of the cerebrospinal fluid and provide a more detailed picture of the cord-column interaction. The study was validated against a parallel in vitro study on bovine tissue. Previous assumptions about complete subdural collapse before any cord deformation were found to be incorrect. Both the presence of the dura mater and the cerebrospinal fluid led to a reduction in the longitudinal strains within the cord. The division of the spinal cord into white and grey matter perturbed the bone fragment trajectory only marginally. In conclusion, the cerebrospinal fluid had a significant effect on the deformation pattern of the cord during impact and should be included in future models. The type of material models used for the spinal cord and the dura mater were found to be important to the stress and strain values within the components, but less important to the fragment trajectory.

An evaluation of methods to determine the porosity of calcium phosphate cements

The porosity of a material can be determined using a diversity of methods; however, the results from these methods have so far not been compared and analyzed for calcium phosphate cements (CPCs). The aim of this study was to compare a fast and easy method for porosity measurements with some commonly used porosity methods for CPCs. The investigated method is based on the assumption that when a wet cement sample is dried, the volume of the evaporated water is equal to the volume of pores within the cement. Moreover, different methods of drying the cements were evaluated for acidic CPCs. The results showed that drying at room temperature (22 ± 1°C) is preferable, since a phase transformation was observed at higher temperatures. The results also showed that drying for 24 h in vacuum was sufficient to achieve water-free cements. The porosity measured was found to vary between the porosity methods evaluated herein, and to get a complete picture of a cements porosity more than one method is recommended. Water evaporation, is, however, a fast and easy method to estimate the porosity of CPCs and could simplify porosity measurements in the future.

The effect of composition on mechanical properties of brushite cements

Due to a fast setting reaction, good biological properties, and easily available starting materials, there has been extensive research within the field of brushite cements as bone replacing material. However, the fast setting of brushite cement gives them intrinsically low mechanical properties due to the poor crystal compaction during setting. To improve this, many additives such as citric acid, pyrophosphates, and glycolic acid have been added to the cement paste to retard the crystal growth. Furthermore, the incorporation of a filler material could improve the mechanical properties when used in the correct amounts. In this study, the effect of the addition of the two retardants, disodium dihydrogen pyrophosphate and citric acid, together with the addition of β-TCP filler particles, on the mechanical properties of a brushite cement was investigated. The results showed that the addition of low amounts of a filler (up to 10%) can have large effects on the mechanical properties. Furthermore, the addition of citric acid to the liquid phase makes it possible to use lower liquid-to-powder ratios (L/P), which strongly affects the strength of the cements. The maximal compressive strength (41.8MPa) was found for a composition with a molar ratio of 45:55 between monocalcium phosphate monohydrate and beta-tricalcium phosphate, an L/P of 0.25ml/g and a citric acid concentration of 0.5M in the liquid phase.

Mechanical and tribological behavior of silicon nitride and silicon carbon nitride coatings for total joint replacements

Total joint replacements currently have relatively high success rates at 10-15 years; however, increasing ageing and an active population places higher demands on the longevity of the implants. A wear resistant configuration with wear particles that resorb in vivo can potentially increase the lifetime of an implant. In this study, silicon nitride (SixNy) and silicon carbon nitride (SixCyNz) coatings were produced for this purpose using reactive high power impulse magnetron sputtering (HiPIMS). The coatings are intended for hard bearing surfaces on implants. Hardness and elastic modulus of the coatings were evaluated by nanoindentation, cohesive, and adhesive properties were assessed by micro-scratching and the tribological performance was investigated in a ball-on-disc setup run in a serum solution. The majority of the SixNy coatings showed a hardness close to that of sintered silicon nitride (~18 GPa), and an elastic modulus close to that of cobalt chromium (~200 GPa). Furthermore, all except one of the SixNy coatings offered a wear resistance similar to that of bulk silicon nitride and significantly higher than that of cobalt chromium. In contrast, the SixCyNz coatings did not show as high level of wear resistance.

Radiopacity of tantalum-loaded acrylic bone cement.

Abstract Radiopacifying agents are commonly added to bone cements to enhance the visibility of the cement in radiography. The radiopacifiers usually employed may, however, have undesired effects on the mechanical properties of the cement. A potentially new radiopacifier is tantalum, which in the present work was evaluated in terms of radiopacity. Bone cements containing different percentages of tantalum were compared with plain bone cement as well as with formulations containing different percentages of the commonly used radiopacifier barium sulphate. The radiopacity was assessed quantitatively and qualitatively, by measuring with a digital densitometer the optical density of the cement on X-ray films, and consulting the expertise of ten orthopaedic surgeons. It was found that tantalum does present radiopacity, but not as high as barium sulphate under the specific conditions applied to this study.

Fabrication and evaluation of SixNy coatings for total joint replacements

Wear particles from the bearing surfaces of joint implants are one of the main limiting factors for total implant longevity. Si3N4 is a potential wear resistant alternative for total joint replacements. In this study, SixNy-coatings were deposited on cobalt chromium-discs and Si-wafers by a physical vapour deposition process. The tribological properties, as well as surface appearance, chemical composition, phase composition, structure and hardness of these coatings were analysed. The coatings were found to be amorphous or nanocrystalline, with a hardness and coefficient of friction against Si3N4 similar to that found for bulk Si3N4. The low wear rate of the coatings indicates that they have a potential as bearing surfaces of joint replacements. The adhesion to the substrates remains to be improved.