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The Role of Poly(Methyl Methacrylate) in Management of Bone Loss and Infection in Revision Total Knee Arthroplasty: A Review
Journal of Functional Biomaterials
  • Leyla Hasandoost
  • Omar Rodriguez
  • Adel Alhalawani
  • Paul Zalzal
  • Emil H. Schemitsch
  • Stephen D. Waldman
  • Marcello Papini
  • Mark R. Towler, Missouri University of science and Technology
Abstract

Poly (methyl methacrylate) (PMMA) is widely used in joint arthroplasty to secure an implant to the host bone. Complications including fracture, bone loss and infection might cause failure of total knee arthroplasty (TKA), resulting in the need for revision total knee arthroplasty (rTKA). The goals of this paper are: (1) to identify the most common complications, outside of sepsis, arising from the application of PMMA following rTKA, (2) to discuss the current applications and drawbacks of employing PMMA in managing bone loss, (3) to review the role of PMMA in addressing bone infection following complications in rTKA. Papers published between 1970 to 2018 have been considered through searching in Springer, Google Scholar, IEEE Xplore, Engineering village, PubMed and weblinks. This review considers the use of PMMA as both a bone void filler and as a spacer material in two-stage revision. To manage bone loss, PMMA is widely used to fill peripheral bone defects whose depth is less than 5 mm and covers less than 50% of the bone surface. Treatment of bone infections with PMMA is mainly for two-stage rTKA where antibiotic-loaded PMMA is inserted as a spacer. This review also shows that using antibiotic loaded PMMA might cause complications such as toxicity to surrounding tissue, incomplete antibiotic agent release from the PMMA, roughness and bacterial colonization on the surface of PMMA. Although PMMA is the only commercial bone cement used in rTKA, there are concerns associated with using PMMA following rTKA. More research and clinical studies are needed to address these complications.

Department(s)
Chemical and Biochemical Engineering
Comments

Guangzhou Research Collaborative Innovation Projects, Grant 356780-DAN

Document Type
Article - Journal
Document Version
Final Version
File Type
text
Language(s)
English
Rights
© 2023 The Authors, All rights reserved.
Creative Commons Licensing
Creative Commons Attribution 4.0
Publication Date
6-1-2020
Publication Date
01 Jun 2020
Citation Information
Leyla Hasandoost, Omar Rodriguez, Adel Alhalawani, Paul Zalzal, et al.. "The Role of Poly(Methyl Methacrylate) in Management of Bone Loss and Infection in Revision Total Knee Arthroplasty: A Review" Journal of Functional Biomaterials Vol. 11 Iss. 2 (2020) ISSN: 2079-4983
Available at: http://works.bepress.com/mark-towler/161/