Abstract
The extended use of acrylic bone cements (ABC) in orthopedics presents some disadvantages related to the generation of high temperatures during methyl methacrylate polymerization, thermal tissue necrosis, and low mechanical properties. Both weaknesses cause an increase in costs for the health system and a decrease in the patient’s quality of life due to the prosthesis’s loosening. Materials such as graphene oxide (GO) have a reinforcing effect on ABC’s mechanical and setting properties. This article shows for the first time the interactions present between the factors sonication time and GO percentage in the liquid phase, together with the percentage of benzoyl peroxide (BPO) in the solid phase, on the mechanical and setting properties established for cements in the ISO 5833-02 standard. Optimization of the factors using a completely randomized experimental design with a factorial structure resulted in selecting nine combinations that presented an increase in compression, flexion, and the setting time and decreased the maximum temperature reached during the polymerization. All of these characteristics are desirable for improving the clinical performance of cement. Those containing 0.3 wt.% of GO were highlighted from the selected formulations because all the possible combinations of the studied factors generate desirable properties for the ABC.
Highlights
Acrylic bone cements (ABC) are biomaterials used since 1960 in orthopedics, and their applications extend from arthroplasty procedures [1] to neurosurgery [2], vertebroplasty, and kyphoplasty [3,4,5]
This article shows for the first time the interactions present between the factors sonication time and graphene oxide (GO) percentage in the liquid phase, together with the percentage of benzoyl peroxide (BPO) in the solid phase, on the mechanical and setting properties established for cements in the ISO 5833-02 standard [51]
The GO thickness determined by Atomic force microscopy (AFM) was
Summary
Acrylic bone cements (ABC) are biomaterials used since 1960 in orthopedics, and their applications extend from arthroplasty procedures [1] to neurosurgery [2], vertebroplasty, and kyphoplasty [3,4,5]. GrapThheenme ioxxtuidreeo(fGBOPO) isanadtwDMo-PdTimpreondsuiocensabl emnzaotyelriraald, iacaglsr,asptahretinneg sPhMeeMtAwpitohlyo- xygen gprliocuaptwpmisoohelnoriycismvzhaeedtcrriouoiizmnetastb[i7tsioon,u1ne1rri]fwet.asaTcicthehthieoi[smg2neh7’usb]le.etmnixUpzoelostechuyhemlararlmoanllydieic,ciccaucGahllleOsasprjoaetaciornttftecorwrraremicmtahtatseaythnsPpeicMlgeamny,MoiafbnAiricoooamclcnheoeatirmnianattnpshtdae[e1ntrfi3motb]iraiom(llFnitniaygeicu,nctirrvobebesii1ioocs)dem.oneftTegetdhhrrsaeei,cdaaltaiopn[26,28p–e3ri1p]r,oasnthdeteicxtciessllueen[t6,a8n],tiinbdaucctienrgiatlhpe rimoppelarntitedse[t3er2i,o3r3a]ti.on [1] Some fillers such as hydroxyapatite (HA) [14,15,16,17], phosphate bioglasses [18,19], silicate and borate bioglasses [20,21], tricalcium phosphates [22,23], Sepia Officinalis cuttlebone [24], and biodegradable polymers such as cellulose, chitosan, polydioxanone [25], polylactic acid (PLA), β-polyhydroxy butyrate (PHB), and thermoplastic starch (TPS) have been added to the solid phase of the cement for improving different properties; due to the inorganic nature of some of them and the biodegradable behavior of others, losses in their mechanical properties have been generated [26]. Some of these combinations have not yet been studied, which broadens the possibilities for new formulations with desirable characteristics to improve ABCs’ clinical performance, which could be used in orthopedics
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