Cement - within - Cement (C-C) revision techniques have been demonstrated to reduce the complications associated with removal of secure cement from the femoral canal during revision hip joint arthroplasty. Material failure at the interface between new and old cement mantles represents a theoretical limitation of this technique. The objectives of this thesis are to describe the variability in material properties of uniform and bilaminar polymethylmethacrylate (PMMA) cement mantles in shear with respect to duration of post-cure and the influence of commercial inclusion of antibiotics on bilaminar cement mantle interfacial shear strength. Uniform mantles of Surgical Simplex P and Antibiotic Simplex PMMA cements demonstrated variability in ultimate shear stress to failure with respect to duration of post-cure (p < 0.001), however the variations were quantitatively small and unlikely to be of clinical relevance. Bilaminar cement mantles were 15 - 20 percent weaker than uniform mantles (p < 0.001) and demonstrated similar time dependant material property variations in shear (p < 0.001). Bilaminar PMMA test specimens manufactured using Antibiotic Simplex cement demonstrated equivalent ultimate shear stress to failure as bilaminar specimens manufactured from Surgical Simplex (p=0.52). High C-C interfacial strengths are demonstrated as early as one hour after cement application. Interfacial adhesion by mechanisms other than mechanical interlock significantly influence the bond formed between layered PMMA cements, with an important contribution by diffusion based molecular interdigitation. In the presence of a secure cement-bone interface, C-C femoral revision can be recommended as a viable technique on the basis of the strong interfacial bond formed between new and old cement mantles. The use of Antibiotic Simplex in C-C revision is recommended as detrimental effects on the interfacial shear properties have not been demonstrated with the commercial addition of Tobramycin.
| Identifer | oai:union.ndltd.org:ADTP/265278 |
| Date | January 2006 |
| Creators | Weinrauch, Patrick Connor |
| Publisher | Queensland University of Technology |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
| Rights | Copyright Patrick Connor Weinrauch |
Page generated in 0.0019 seconds