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Methyl methacrylate (MMA) is the basic component of bone cements. To use it, a dough is prepared from the liquid and powder by mixing right before application, which is normally done by the operating team. During its working phase the dough is then inserted into the tissue where polymerization is completed. Thus, the final implant polymethyl methacrylate (PMMA) is only created at the implantation site. Besides methyl methacrylate, bone cements sometimes contain other methacrylates, such as butyl methacrylate. To achieve X-ray opacity, radiopacifiers (zirconium dioxide or barium sulfate) are added to the powder. Both the liquid and powder components contain additives (initiator and activator) that launch polymerization and control the set ting when mixed together. Moreover, softener and emulsifiers are some times used. The addition of antibiotics to the powder component in order to prevent or treat infections has become especially important. Commercial bone cements differ in composition and the course of curing. Some are designed for high and others for low viscosity. The way the user handles and applies the cement always crucially influences the quality of the implant. This is why clear and comprehensive information about the cements should be available to show the user how all the relevant factors work It should also be possible together and how they depend on each other."
Musculosketal infections are potentially devastating for the patient, his family and the health care services, as they may lead to functional impairment, long lasting disability, or even permanent handicap. This problem may also have socioeconomic implications. Infection commonly results in prolonged use of antibiotics, multiple operations, complications, extended rehabilitation and long lasting followup visits with additional costs for the health care provider. This book covers contributions from international experts who came together in Potsdam, Germany, at the invitation of Professor Heino Kienapfel, MD PhD, of the Department of Special Orthopaedic Surgery and Traumatology of the Centre of Joint Arthroplasty, Auguste Viktoria Clinics Berlin. The focus of this book is the state of the art of: -Antimicrobial Resistances: Facts and Statistics - Arthroplasty Registers in EU: Status and Development - Microbiology in Arthroplasty - Strategies in Antibiotic Treatment - Spacer Management: Clinical Experiences and Requirements - Biofilm Creation: Low Grade Infection - Revision: Cemented vs. Cementless - Revision: One-stage vs. Two-stage treatment
The Editors of "Essentials of Cemented Knee Arthroplasty" have compiled a comprehensive textbook on what many consider the most successful surgical procedure of the century. This book rounds out the compendium previously published by Springer on arthroplasty related topics: "The Well Cemented Total Hip Arthroplasty", "PMMA Cements", and "Management of Periprosthetic Joint Infection". Unique to this text is the high quality contributions from over 160 world wide experts in the field, and provides a unique international perspective on the multifaceted topic of knee replacement surgery. Sections include a focus on Surgical Indications, Implant Design, Novel Technologies, Complications, and Cementing Technique, amongst others. Each Chapter not only draws on the most current literature on the subject, but also crystalizes the most important points into clinically relevant, practically applicable "take home messages". This singular text is notable for not only its breadth, but also its depth, and will be an invaluable resource for knee arthroplasty surgeons throughout the globe.
Cementing endoprostheses is one of the most frequently performed orthopedic procedures in the world today. PMMA cements are used to anchor artificial joints. They fill up the free space between the prosthesis and bone and constitute a very important elastic zone. Owing to their optimal rigidity the cement can evenly buffer the forces acting against the bone. Although the bone cement which are currently commercially available are all based on the same chemical substance (methyl methacrylate = MMA), their physical and chemical properties differ. The completely revised second addition of the book "PMMA (Bone) Cements" could not have a better timing. In a contemporary overview about biological, physical and chemical characteristics of PMMA cement, physicians, material developers, pharmacists, microbiologist, and economists should gain a basic understanding of the subject. It should also serve them as a reference book. In particular for future physicians and hospital personnel numerous questions will be addressed which have been posed during trainings, congresses and expert gatherings concerning the use of PMMA cement in the operating theater in a save and competent way. Also for decision makers at the hospital administration a comprehensive platform has been created which can be used as a basis of their assessment.
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