• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.753-767
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• 2002

The purpose of this study was to evaluate histologically the effect of LiF-maleic acid added calcium aluminate(LM-CA) bone cement & CA-PMMA composite bone cement on the healing of calvarial defect in Sprague-Dawley rats. The critical size defects were surgically produced in the calvarial bone using the 8mm trephine bur. The rats were divided in three groups : In the control group, nothing was applied into the defect of each rat. LM-CA bone cement was implanted in the experimental group 1 and CA-PMMA composite bone cement was implanted in the experimental group 2. Rats were sacrificed at 2, 8 weeks after surgical procedure. The specimens were examined by histologic analysis, especially about the bone-cement interface and the response of surrounding tissue. The results are as follows; 1. In the control group, inflammatory infiltration was observed at 2 weeks. At 8 weeks, periosteum and duramater were continuously joined together in the defect area. But the center of defect area was filled up with the loose connective tissue. 2. In the experimental group 1, the bonding between implanted bone cement and the existing bone was seen, which more increased in 8 weeks than 2 weeks. Inflammatory infiltration and the dispersion of implanted bone cement particles were seen in both 2 weeks and 8 weeks. 3. In the experimental group 2, implanted bone itself had a dimensional stability and no bonding between implanted bone cement and the existing bone was seen in both 2 weeks and 8 weeks. Implanted bone cement was encapsulated by fibrous connective tissue. In addition, inflammatory infiltration was seen around implanted bone cement. On the basis of these results, when LM-CA bone cement or CA-PMMA composite bone cement was implanted in rat calvarial defect, LM-CA bone cement can be used as a bioactive bone graft material due to ability of bonding to the existing bone and CA-PMMA can be used as a graft material for augmentation of bone-volume due to dimensional stability.

• Journal of Korean Neurosurgical Society
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• v.52 no.5
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• pp.435-440
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• 2012

Objective : The purpose of this study is to find the optimal stiffness and volume of bone cement and their biomechanical effects on the adjacent vertebrae to determine a better strategy for conducting vertebroplasty. Methods : A three-dimensional finite-element model of a functional spinal unit was developed using computed tomography scans of a normal motion segment, comprising the T11, T12 and L1 vertebrae. Volumes of bone cement, with appropriate mechanical properties, were inserted into the trabecular core of the T12 vertebra. Parametric studies were done by varying the volume and stiffness of the bone cement. Results : When the bone cement filling volume reached 30% of the volume of a vertebral body, the level of stiffness was restored to that of normal bone, and when higher bone cement exceeded 30% of the volume, the result was stiffness in excess of that of normal bone. When the bone cement volume was varied, local stress in the bony structures (cortical shell, trabecular bone and endplate) of each vertebra monotonically increased. Low-modulus bone cement has the effect of reducing strain in the augmented body, but only in cases of relatively high volumes of bone cement (>50%). Furthermore, varying the stiffness of bone cement has a negligible effect on the stress distribution of vertebral bodies. Conclusion : The volume of cement was considered to be the most important determinant in endplate fracture. Changing the stiffness of bone cement has a negligible effect on the stress distribution of vertebral bodies.

• Macromolecular Research
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• v.13 no.2
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• pp.120-127
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• 2005

Conventional poly(methyl methacrylate) (PMMA) bone cement has been widely used as an useful biopolymeric material to fix bone using artificial prostheses. However, many patients had to be reoperated, due to the poor mechanical and thermal properties of conventional PMMA bone cement, which are derived from the presence of unreacted MMA liquid, the shrinkage and bubble formation that occur during the curing process of the bone cement, and the high curing temperature ($above 100^{\circ}C$) which has to be used. In the present study, a composite PMMA bone cement was prepared by impregnating conventional PMMA bone cement with ultra high molecular weight polyethylene (UHMWPE) powder, in order to improve its mechanical and thermal properties. The UHMWPE powder has poor adhesion with other biopolymeric materials due to the inertness of the powder surface. Therefore, the surface of the UHMWPE powder was modified with two kinds of silane coupling agent containing amino groups (3-amino propyltriethoxysilane ($TSL 8331^{R}$) and N-(2-aminoethyl)-3-(amino propyltrimethoxysilane) ($TSL 8340^{R}$)), in order to improve its bonding strength with the conventional PMMA bone cement. The tensile strengths of the composite PMMA bone cements containing $3 wt\%$ of the UHMWPE powder surface-modified with various ratios of $TSL 8331^{R}$ and $TSL 8340^{R}$ were similar or a little higher than that of the conventional PMMA bone cement. However, no significant difference in the tensile strengths between the conventional PMMA bone cement and the composite PMMA bone cements could be found. However, the curing temperatures of the composite PMMA bone cements were significantly decreased.

• Proceedings of the KOSOMBE Conference
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• v.1996 no.11
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• pp.337-346
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• 1996

Debonding of cement-femoral stem interface has been suggested as a initial focus of loosening mechanism in many previous studies of cemented total hip replacement. The purpose of this study was to investigate the effect of debonding of cement-femoral stem interface to the bone-cement interface by using three-dimensional non-liner finite element analysis. Three cases of partial debonded, full debonded, full bonded cement-bone interface were modelled with partial bonding of distal 70mm from the tip of femoral stem. Each situation was studied under loading stimulating one-leg stanced gait of 68kg patient. The results showed that under partial and full debonded cement-stem interface condition the peak von Mises stress(3.1 MPa) were observed at the cement of bone-cement interface just under the calcar of proximal medial of femur, and sudden high peak stresses(3.5MPa) were developed at the distal tip of femoral stem at the lateral bone-cement interface in all 3 cases of bonding. The stresses were transfered very little to the cement of upper lateral bone-cement interface in partial and full debonded cases. Thus, once partial or full debonded cement-femoral stem interface occured, 3 times higher stress concentration were developed on the cement of proximal medial bone-cement interface than full bonded interface, and these could cause loosening of cemented total hip replacement. Clinically, preservation of more rigid cement-femoral stem interface may be important factor to prevent loosening of femoral stem.

• Journal of Medicine and Life Science
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• v.20 no.2
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• pp.60-66
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• 2023

Gentamicin-loaded bone cement used in total joint arthroplasty is indispensable, as it provides stability by directly binding the surfaces of implants and bones. Depending on multiple factors, including the material of the bone cement used, common complications, such as aseptic loosening, osteolysis, and infection can occur postoperatively. In clinical practice, Doujet bone cement is easy to handle (pre-packed all-in-one system), and has shown low failure rates and non-inferior results compared with similar available products. We conducted a retrospective comparative study to analyze the clinical and radiological results of each bone cement group to establish the safety and usefulness of Doujet bone cement. From July 2020 to July 2022, we enrolled 198 patients in this study after an average follow-up period of 37 months (range, 6-48 months). In 99 patents, Doujet^® bone cement (Injecta, Gunpo, Korea) was used for total knee arthroplasty (TKA), while Refobacin^® bone cement (Biomet, Warsaw, IN, USA) was used in 99 patients. The average range of motion (ROM) of the knee increased by 2.4° (from 127.0° preoperatively to 129.4° postoperatively) in the Doujet group, and by 0.1° (from 128.7° to 128.8°) in the Refobacin group (P=0.701). The Western Ontario and McMaster Universities (WOMAC) osteoarthritis index scores decreased from 44.1 to 7.8 in the Doujet group, and from 44.2 to 6.3 in the Refobacin group (P=0.162). Complications, such as osteolysis or post-operative wound infection, did not occur in more than two cases in both groups. The WOMAC and ROM of the knee in both groups had no clinical differences. Both Doujet and Refobacin similarly showed low complication rates after TKA.

• Journal of Korean Neurosurgical Society
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• v.57 no.5
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• pp.367-370
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• 2015

Bone cement augmentation procedures have been getting more position as a minimally invasive surgical option for osteoporotic spinal fractures. However, complications related to these procedures have been increasingly reported. We describe a case of bone cement dislodgement following cement augmentation procedure for osteoporotic spinal fracture by reviewing the patient's medical records, imaging results and related literatures. A 73-year-old woman suffering back and buttock pain following a fall from level ground was diagnosed as an osteoporotic fracture of the 11th thoracic spine. Percutaneous kyphoplasty was performed for this lesion. Six weeks later, the patient complained of a recurrence of back and buttock pain. Radiologic images revealed superior dislodgement of bone cement through the 11th thoracic superior endplate with destruction of the lower part of the 10th thoracic spine. Staged anterior and posterior fusion was performed. Two years postoperatively, the patient carries on with her daily living without any significant disability. Delayed bone cement dislodgement can occur as one of complications following bone cement augmentation procedure for osteoporotic spinal fracture. It might be related to the presence of intravertebral cleft, lack of interdigitation of bone cement with the surrounding trabeculae, and possible damage of endplate during ballooning procedure.

• Journal of the Korean Ceramic Society
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• v.55 no.5
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• pp.480-491
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• 2018

Calcium phosphates (CaP) were prepared by a wet chemical method. Micro-crystalline dicalcium phosphate (DCPD) was precipitated at $37^{\circ}C$ and pH 5.0 using $Ca(OH)_2$ and $H_3PO_4$. The precipitated DCPD solution was kept at $37^{\circ}C$ for 96 h. Artificial bone cement was composed of DCPD, $Ca(H_2PO_4)_2{\cdot}H_2O$ (MCPM), and $CaSO_4{\cdot}1/2H_2O$, $H_2O$ and aqueous poly-phosphoric acid solution. The wet prepared CaP powder was used as a matrix for the bone cement recipe. With the addition of aqueous poly-phosphoric acid, the cement hardening reaction was started and the CaP bone cement blocks were fabricated for the mechanical strength measurement. For the tested blocks, the mechanical strength was measured using a universal testing machine, and the microstructure phase analysis was done by field emission scanning electron microscopy and X-ray diffraction. The cement hardening reaction occurred through the decomposition and recrystallization of MCPM and $CaSO_4{\cdot}1/2H_2O$ added on the surface of the wet prepared CaP, and this resulted in grain growth in the bone cement block.

• Structural Engineering and Mechanics
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• v.66 no.1
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• pp.37-43
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• 2018

In orthopedic surgery and in particular in total hip arthroplasty, the implant fixation is carried out using a surgical cement called polymethylmethacrylat (PMMA). This cement has to insure a good adhesion between implant and bone and a good load distribution to the bone. By its fragile nature, the cement can easily break when it is subjected to a high stress gradient by presenting a craze zone in the vicinity of inclusion. The focus of this study is to analyze the effect of inclusion in some zone of cement in which the loading condition can lead to the crack opening leading to their propagation and consequently the aseptic loosening of the THR. In this study, the fracture behavior of the bone cement including a strange body (bone remain) from which the onset of a crack is supposed. The effect of loading condition, the geometry, the presence of both crack and inclusion on the stress distribution and the fracture behavior of the cement. Results show that the highest stresses are located around the sharp tip of bony inclusion. Most critical cracks are located in the middle of the cement mantle when they are subjected to one leg standing state loading during walking.

• Advances in materials Research
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• v.3 no.1
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• pp.271-281
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• 2014

The presence of cavities in the bone cement has a great importance for the transport of antibiotics, but its existence in this material can lead to its weakening by notch effect. The aim of this study allows providing a physical interpretation to the cavities interconnection by cracks observed experimentally. The most important stress of Von Mises is localized at the cement/bone interface near the free edge which is the seat of stress concentration. The presence and interaction of cavities in this site concentrate, by notch effect, stresses which tend to the tensile fracture stress of Bone cement.

• Journal of Korean Neurosurgical Society
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• v.61 no.1
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• pp.114-119
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• 2018

Objective : The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique. Methods : Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study. The indications for screw fixation in the previously augmented vertebrae with bone cement included delayed complications, such as cement dislodgement, cement leakage with neurologic deficits, and various degenerative spinal diseases, such as spondylolisthesis or foraminal stenosis. Clinical outcomes, including pain scale scores, cement distribution pattern, and procedure-related complications were assessed. Results : Three patients underwent posterior screw fixation in previously cemented vertebrae due to cement dislodgement or progressive kyphosis. Three patients required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight patients underwent posterior screw fixation due to various degenerative spinal diseases. It was possible to insert screws in the previously augmented vertebrae regardless of the cement distribution pattern; however, screw insertion was more difficult and changed directions in the patients with cemented vertebrae exhibiting a solid pattern rather than a trabecular pattern. All patients showed significant improvements in pain compared with the preoperative levels, and no patient experienced neurologic deterioration as seen at the final follow-up. Conclusion : For patients with vertebrae previously augmented with bone cement, posterior screw fixation is not a contraindication, but is a feasible option.