Cement from nanocrystalline hydroxyapatite: effect of calcium phosphate ratio.

Nanocrystalline hydroxyapatite (nHA) can be mixed with phosphoric acid to form a brushite cement; a degradable inorganic bone filling material. nHA was precipitated from reactants of calcium to phosphate (Ca/P) ratio 0.8 to 2.0 and mixed with phosphoric acid, which resulted in the formation of a brushite cement. Cement was also formed by mixing microcrystalline calcium phosphates, beta-tricalcium phosphate, hydroxyapatite and tetracalcium phosphate with phosphoric acid solution. Cement produced with nHA was stronger in compression than that formed with crystalline calcium phosphate phases. Setting time, strength and composition of cement produced with nHA was dependant on both the Ca/P ratio of nHA and the concentration of phosphoric acid in cement slurry. Increasing phosphoric acid concentration increased compressive strength whilst reducing the initial setting time of cement. Reducing the Ca/P ratio of nHA precipitation reactants retarded the setting and increased the extent of reaction of cements. This finding was unexpected and suggests that Ca/P ratio may strongly affect dissolution behaviour and this parameter is more important than stoichiometry in determining extent of reaction in this system. This study demonstrated that the wide variation in stoichiometry that may be attained in nanocrystalline apatite may be utilised to change cement performance and setting behaviour.

Cement from magnesium substituted hydroxyapatite.

Brushite cement may be used as a bone graft material and is more soluble than apatite in physiological conditions. Consequently it is considerably more resorbable in vivo than apatite forming cements. Brushite cement formation has previously been reported by our group following the mixture of nanocrystalline hydroxyapatite and phosphoric acid. In this study, brushite cement was formed from the reaction of nanocrystalline magnesium-substituted hydroxyapatite with phosphoric acid in an attempt to produce a magnesium substituted brushite cement. The presence of magnesium was shown to have a strong effect on cement composition and strength. Additionally the presence of magnesium in brushite cement was found to reduce the extent of brushite hydrolysis resulting in the formation of HA. By incorporating magnesium ions in the apatite reactant structure the concentration of magnesium ions in the liquid phase of the cement was controlled by the dissolution rate of the apatite. This approach may be used to supply other ions to cement systems during setting as a means to manipulate the clinical performance and characteristics of brushite cements.

Degradation of poly-L-lactide. Part 2: increased temperature accelerated degradation.

Poly-L-lactide (PLLA) is one of the most significant members of a group of polymers regarded as bioresorbable. The degradation of PLLA proceeds through hydrolysis of the ester linkages in the polymer's backbone; however, the time for the complete resorption of orthopaedic devices manufactured from PLLA is known to be in excess of five years in a normal physiological environment. To evaluate the degradation of PLLA in an accelerated time period, PLLA pellets were processed by compression moulding into tensile test specimens, prior to being sterilized by ethylene oxide gas (EtO) and degraded in a phosphate-buffered solution (PBS) at both 50 degrees C and 70 degrees C. On retrieval, at predetermined time intervals, procedures were used to evaluate the material's molecular weight, crystallinity, mechanical strength, and thermal properties. The results from this study suggest that at both 50 degrees C and 70 degrees C, degradation proceeds by a very similar mechanism to that observed at 37 degrees C in vitro and in vivo. The degradation models developed also confirmed the dependence of mass loss, melting temperature, and glass transition temperature (Tg) on the polymer's molecular weight throughout degradation. Although increased temperature appears to be a suitable method for accelerating the degradation of PLLA, relative to its physiological degradation rate, concerns still remain over the validity of testing above the polymer's Tg and the significance of autocatalysis at increased temperatures.

Cements from nanocrystalline hydroxyapatite.

Calcium phosphate cements are used as bone substitute materials because they may be moulded to fill a void or defect in bone and are osteoconductive. Although apatite cements are stronger than brushite cements, they are potentially less resorbable in vivo. Brushite cements are three-component systems whereby phosphate ions and water react with a soluble calcium phosphate to form brushite (CaHPO4 x 2H2O). Previously reported brushite cement formulations set following the mixture of a calcium phosphate, such as beta-tricalcium phosphate (beta-TCP), with an acidic component such as H3PO4 or monocalcium phosphate monohydrate (MCPM). Due to its low solubility, hydroxyapatite (HA) is yet to be reported as a reactive component in calcium phosphate cement systems. Here we report a new cement system setting to form a matrix consisting predominantly of brushite following the mixture of phosphoric acid with nanocrystalline HA. As a result of the relative ease with which ionic substitutions may be made in apatite this route may offer a novel way to control cement composition or setting characteristics. Since kinetic solubility is dependent on particle size and precipitation temperature is known to affect precipitated HA crystal size, the phase composition and mechanical properties of cements made from HA precipitated at temperatures between 4 and 60 degrees C were investigated.

Processing, annealing and sterilisation of poly-L-lactide.

Poly-L-lactide (PLLA) is one of the most significant members of a group of polymers regarded as bioabsorbable. Degradation of PLLA proceeds through hydrolysis of the ester bonds in the polymer chains and is influenced significantly by the polymer's molecular weight and crystallinity. To evaluate the effects of processing and sterilisation on these properties, PLLA pellets were either compression moulded or extruded, subjected to annealing at 120 degrees C for 4h and sterilised by ethylene oxide (EtO) gas. Procedures were used to evaluate the mechanical properties, molecular weight and crystallinity. Upon processing, the crystallinity of the material fell from 61% for the PLLA pellets to 12% and 20% for the compressed and extruded components, respectively. After annealing, crystallinity increased to 43% for the compression-moulded material and 40% for the extruded material. Crystallinity further increased upon EtO sterilisation. A slight decrease in molecular weight was observed for the extruded material through processing, annealing and sterilisation. Young's modulus generally increased with increasing crystallinity, and extension at break and tensile strength decreased. The results from this investigation suggest that PLLA is sensitive to processing and sterilisation, altering properties critical to its degradation rate.

Creep behavior of bone cement: a method for time extrapolation using time-temperature equivalence.

The clinical lifetime of poly(methyl methacrylate) (PMMA) bone cement is considerably longer than the time over which it is convenient to perform creep testing. Consequently, it is desirable to be able to predict the long term creep behavior of bone cement from the results of short term testing. A simple method is described for prediction of long term creep using the principle of time-temperature equivalence in polymers. The use of the method is illustrated using a commercial acrylic bone cement. A creep strain of approximately 0.6% is predicted after 400 days under a constant flexural stress of 2 MPa. The temperature range and stress levels over which it is appropriate to perform testing are described. Finally, the effects of physical aging on the accuracy of the method are discussed and creep data from aged cement are reported.

Hydrolytic degradation of polyglyconate B: the relationship between degradation time, strength and molecular weight.

Bioresorbable polymers have found a wide range of uses in medical implants, from sutures to scaffolds for tissue engineering applications. Increasingly they are being used in internal orthopaedic fixation devices, in which the strength retention profile is important. Polyglyconate B, a block co-polymer of glycolic acid and trimethylene carbonate, is one polymer used in these applications. In this study, the hydrolytic degradation of polyglyconate B has been studied in vitro. Specimens were prepared with two initial molecular weights and aged in PBS solution at 37 degrees C for up to 31 days. The polymers were characterised by gel permeation chromatography. for molecular weight, tensile testing and mass change, as a function of degradation time. A further aim of the work was to determine whether the measured changes in tensile strength over time could be fitted to a simple model. The results showed that the observed relationship between strength and molecular weight was more complex than that used in our model. However, the data could be modelled using an empirically derived relationship between tensile strength and number average molecular weight (Mn). Changes in other mechanical properties, such as strain at break, were also found to be strongly dependent on changes in the single parameter of Mn.

Rheological properties of PMMA bone cements during curing.

The rheological behaviour of poly(methyl methacrylate) bone cements has been characterised during the curing phase using an oscillating parallel plate rheometer. Viscosity has been measured as a function of time for a range of commercial cements showing different viscosity-time profiles. Measurements have been made over a range of temperatures from 19-25 degrees C, and the results show a strong dependence of rate of viscosity rise on temperature. Viscoelastic parameters, such as storage modulus, loss modulus and phase angle have been obtained and show the change from primarily viscous to elastic behaviour as the cements set. It is suggested that these parameters more completely describe the rheological behaviour of bone cements than viscosity alone and may provide a better measure of handling and setting characteristics.

The microstructure of ultra-high molecular weight polyethylene used in total joint replacements.

The microstructure of ultra-high molecular weight polyethylene (UHMWPE) has been studied using a range of techniques. Both the unprocessed base powder and ram-extruded polymer have been examined using optical microscopy, scanning and transmission electron microscopy and small-angle light scattering. By examining the microstructure of samples compression moulded at a range of temperatures, techniques have been developed to assess the degree of consolidation of the processed polymer. The raw polymer is a powder with a particle size in the range 50-250 microm. These particles are themselves agglomerates of much finer particles typically 0.5-1 microm in size. It has been suggested that these sub-micron particles may be the origin of the sub-micron wear debris found in tissues around total joint replacements. However, examination of the ram-extruded polymer, from which implants are machined, shows a different structure from the powder, with no evidence of retention of the 0.5-1 microm structure seen in the powder in the processed material. It thus appears that the similarity in size between the sub-micron wear debris particles and the fine structure seen in the unprocessed UHMWPE resin is coincidental. Processed UHMWPE does show a 'memory' of the grain boundaries between powder particles and the degree of consolidation can be assessed by observing the distinctiveness of these boundaries.