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Materials (Basel). 2016 Oct 6;9(10). pii: E821. doi: 10.3390/ma9100821.

A Review of PMMA Bone Cement and Intra-Cardiac Embolism.

Author information

1
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. pus8@pitt.edu.
2
Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. yanfeichen@pitt.edu.
3
Division of Cardiology, Allegheny General Hospital, Pittsburgh, PA 15212, USA. rkhalil@ahn.org.
4
Bone and Joint Center at Magee-Women's Hospital of UPMC, Pittsburgh, PA 15213, USA. plakap@upmc.edu.
5
Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15213, USA. skcho@pitt.edu.
6
Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213 USA. tillmanbw@pitt.edu.
7
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. skcho@pitt.edu.
8
McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA. skcho@pitt.edu.
9
Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. skcho@pitt.edu.
10
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. yjchun@pitt.edu.
11
Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. yjchun@pitt.edu.
12
McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA. yjchun@pitt.edu.

Abstract

Percutaneous vertebroplasty procedure is of major importance, given the significantly increasing aging population and the higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving the injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main effects of PMMA bone cement on the heart, and the extent of influence of the materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case reports.

KEYWORDS:

PMMA;  bone cement;  cardiac embolism;  cement leakage;  viscosity

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