Shear properties of bilaminar polymethylmethacrylate cement mantles in revision hip joint arthroplasty

J Arthroplasty. 2007 Apr;22(3):394-403. doi: 10.1016/j.arth.2006.04.010. Epub 2007 Jan 22.

Abstract

Although cement-within-cement revision arthroplasty minimizes the complications associated with removal of secure PMMA, failure at the interfacial region between new and old cement mantles remains a theoretical concern. This article assesses the variability in shear properties of bilaminar cement mantles related to duration of postcure and the use of antibiotic cements. Bilaminar cement mantles were 15% to 20% weaker than uniform mantles (P < .001) and demonstrated variability in shear strength related to duration of postcure of the freshly applied cement (P < .001). The use of Antibiotic Simplex did not significantly influence interfacial cement adhesion (P = .52). Interfacial adhesion by mechanisms other than mechanical interlock plays a significant role in the bond formed between new and old PMMA cements, with an important contribution by diffusion-based molecular interdigitation. In the presence of a secure cement-bone interface, we recommend cement-within-cement revision techniques in suitable patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Arthroplasty, Replacement, Hip*
  • Bone Cements / pharmacology*
  • Cementation
  • Finite Element Analysis
  • Humans
  • Materials Testing
  • Polymethyl Methacrylate / pharmacology*
  • Reoperation
  • Tobramycin / administration & dosage

Substances

  • Anti-Bacterial Agents
  • Bone Cements
  • Polymethyl Methacrylate
  • Tobramycin