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- Compressive strength (3)
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- Osteoporotic vertebral fracture (3)
- Bone regeneration (2)
- Feuchte (2)
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- Large animal model sheep (2)
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Organisationseinheit der BAM
Vertebroplasty or kyphoplasty of osteoporotic vertebral fractures bears the risk of pulmonary cement embolism (3.5%–23%) caused by leakage of commonly applied acrylic polymethylmethacrylate (PMMA) cement to spongious bone marrow or outside of the vertebrae. Ultraviscous cement and specific augmentation systems have been developed to reduce such adverse effects. Rapidly setting, resorbable, physiological calcium phosphate cement (CPC) may also represent a suitable alternative.
PURPOSE: This study aimed to compare the intravertebral extrusion of CPC and PMMA cement in an ex vivo and in vivo study in sheep.
STUDY DESIGN/SETTING: A prospective experimental animal study was carried out. METHODS: Defects (diameter 5 mm; 15 mm depth) were created by a ventrolateral percutane-ous approach in lumbar vertebrae of female Merino sheep (2–4 years) either ex vivo (n = 17) or in vivo (n = 6), and injected with: (1) CPC (L3); (2) CPC reinforced with 10% poly(l-lactide-co-glycolide) (PLGA) fibers (L4); or (3) PMMA cement (L5; Kyphon HV-R). Controls were untouched (L1) or empty defects (L2). The effects of the cement injections were assessed in vivo by blood gas analysis and ex vivo by computed tomography (CT), micro-CT (voxel size: 67 µm), histology, and biomechanical testing.
In this in vitro study, the protective qualities of different mouthguard types were examined during small hard object collisions. The aim was to investigate inconclusive aspects of hard inserts, nylon nets, and air spaces as reinforcements in the anterior region and the protection qualities of ethylene vinyl acetate (EVA).
Five different mouthguards with a labial thickness between 2 mm and 11 mm made of materials of varying stiffness were investigated. As a negative control, the same experiments were performed without a mouthguard. Different combinations of EVA and labial inserts ((polyethylene terephthalate glycol-modified [PETG]), nylon mesh, air space) were tested. Using a stainless steel pendulum device, blows of different energy (0.07-2.85 joules) were applied to the center of the crown of a pivoted tooth in a custom-built jaw model. A laser Doppler vibrometer measured the tooth deflection, while an acceleration sensor attached to the pendulum measured the braking accelerations.
Tooth deflection was reduced up to 99.7% compared to no mouthguard, and the braking acceleration was reduced up to 72.2% by increasing the mouthguards' labial thickness in combination with labial inserts of different stiffness and a built-in air space between the front teeth and the mouthguard. The mouthguards made of soft materials (EVA with nylon mesh) showed slightly better protection qualities than the more rigid mouthguards of similar thickness (PETG; P<.05). However, with increasing impact energy, their protective capacities decreased to a greater extent than the stiffer mouthguards.
The combination of increased labial thickness and labial inserts of varying stiffness and eventually an air space offers the best protection capacities for hard, small object collisions.
block and mortar types is analysed with particular regard to the influence of varying relative humidity. The uniaxial compressive strength and deformation characteristics of unstabilised earth blocks and mortars as well as of unstabilised earth block masonry are studied in detail and compared to conventional masonry to evaluate whether the structural design can be made accordingly. An increase of 30 % points in relative humidity leads to a reduction of the masonry´s compressive strength between 33 % and 35 % whereas the Young´s modulus is reduced by 24–29 %. However, the ratio between the Young´s modulus and the characteristic compressive strength of earth block masonry ranges between E33/fk = 283–583 but is largely independent of the relative humidity. The results show that the mechanical properties of the investigated unstabilised earth block masonry are sufficient for load-bearing structures, yielding a masonry compressive strength between 2.3 MPa and 3.7 MPa throughout the range of moisture contents
investigated. In general, the design concept of conventional masonry can be adapted for unstabilised earth masonry provided that the rather low Young´s modulus as well as the moisture dependence of both, compressive strength and Young´s modulus, are sufficiently taken into
account.
Die Bemessung von tragendem Lehmmauerwerk erfolgt in Deutschland auf Basis der Lehmbau Regeln. Das dort verankerte Nachweisverfahren beruht auf einem globalen Sicherheitskonzept, welches aus zuverlässigkeitstheoretischer Sicht nicht mehr dem Stand der Technik entspricht. Auf Grund dessen wird das Bemessungskonzept für Lehmmauerwerk vom Deutschen Institut für Bautechnik (DIBt) voraussichtlich 2023 außer Kraft gesetzt. Ein statischer Nachweis von tragenden Lehmbauten wäre in Deutschland dann ausschließlich mit einer Zustimmung im Einzelfall (ZiE) oder vorhabenbezogener Bauartgenehmigung (vBg) möglich. Beides ist mit erheblichem Mehraufwand und höheren Kosten verbunden, was für den Lehmmauerwerksbau einen entscheidenden Nachteil im Vergleich zum konventionellen Mauerwerksbau darstellt. Um eine unkomplizierte Praxisanwendung von Lehmmauerwerk zu ermöglichen, werden innerhalb eines Forschungsvorhabens, welches von der Bundesanstalt für Materialforschung und -prüfung (BAM), dem Institut für Massivbau der Technischen Universität Darmstadt sowie dem Ingenieurbüro ZRS durchgeführt wird, auf Basis der Produktnormen für Lehmsteine und Lehmmauermörtel Grundlagen für ein aktualisiertes Bemessungskonzept entwickelt. Im Rahmen des Projekts wird ebenfalls untersucht, inwiefern die Bemessungsregeln nach den vereinfachten Berechnungsmethoden für unbewehrtes Mauerwerk gemäß DIN EN 1996-3 / NA auf den Lehmmauerwerksbau übertragbar sind. Falls eine Anwendung des normativen Nachweisverfahrens bei Lehmmauerwerk möglich ist, wäre zukünftig eine Aufnahme von Lehmsteinen und Lehmmauermörtel in den nationalen Anhang des Eurocode 6 denkbar, was eine bedeutsame Erweiterung des Anwendungsbereichs von Lehmmauerwerk zur Folge hätte.
Diverse wissenschaftliche Untersuchungen konnten zeigen, dass bemessungsrelevante Festigkeits- und Verformungseigenschaften von Lehmmauerwerksbaustoffen stark von der vorherrschenden Materialfeuchte abhängen, welche im hygroskopischen Wassergehaltsbereich im Wesentlichen von der relativen Luftfeuchte (RLF) bestimmt wird. Auch die Zwischenergebnisse des laufenden Forschungsvorhabens zur Entwicklung eines Bemessungskonzepts für Lehmmauerwerk ergaben eine deutlich erkennbare Abhängigkeit zwischen der Materialfeuchte und den relevanten Festigkeits- und Verformungseigenschaften. Eine detaillierte Kenntnis des feuchteabhängigen Materialverhaltens von Lehmsteinen, -mörtel und -mauerwerk ist zwingend erforderlich, um ein konsistentes und zuverlässiges Bemessungskonzept für Lehmmauerwerk zu entwickeln. Im Rahmen des laufenden Forschungsprojektes werden deshalb umfangreiche Versuche zum Drucktragverhalten von Lehmsteinen und -mörtel sowie Lehmmauerwerk nach Konditionierung bei unterschiedlichen RLF durchgeführt und analysiert. Weiterhin werden auf Basis der experimentellen Ergebnisse numerische Modelle kalibriert, welche die detaillierte Analyse der Biegedrucktragfähigkeit von Lehmmauerwerk ermöglichen.
In diesem Beitrag werden zunächst die bisherigen Zwischenergebnisse bezüglich der experimentell ermittelten feuchteabhängigen Materialkennwerte von Lehmsteinen, -mörtel und -mauerwerk dargelegt. Darauf aufbauend werden numerische Untersuchungen zur Bestimmung der Systemtragfähigkeit von Lehmmauerwerk unter Feuchteeinflusses durchgeführt und erläutert.
Large animal models are highly recommended for meaningful preclinical studies, including the optimization of cement augmentation for vertebral body defects by vertebroplasty/kyphoplasty.
The aim of this study was to perform a systematic characterization of a strictly minimally invasive in vivo large animal model for lumbar ventrolateral vertebroplasty.
This is a prospective experimental animal study.
Lumbar defects (diameter 5 mm; depth approximately 14 mm) were created by a ventrolateral percutaneous approach in aged, osteopenic, female sheep (40 Merino sheep; 6–9 years; 68–110 kg). L1 remained untouched, L2 was left with an empty defect, and L3 carried a defect injected with a brushite-forming calcium phosphate cement (CPC). Trauma/functional impairment, surgical techniques (including drill sleeve and working canula with stop), reproducibility, bone defects, cement filling, and functional cement augmentation were documented by intraoperative incision-to-suture time and X-ray, postoperative trauma/impairment scores, and ex vivo osteodensitometry, microcomputed tomography (CT), histology, static/fluorescence histomorphometry, and biomechanical testing.
Minimally invasive vertebroplasty resulted in short operation times (28±2 minutes; mean±standard error of the mean) and X-ray exposure (1.59±0.12 minutes), very limited local trauma (score 0.00±0.00 at 24 hours), short postoperative recovery (2.95±0.29 hours), and rapid decrease of the postoperative impairment score to 0 (3.28±0.36 hours). Reproducible defect creation and cement filling were documented by intraoperative X-ray and ex vivo conventional/micro-CT. Vertebral cement augmentation and osteoconductivity of the CPC was verified by osteodensitometry (CPC>control), micro-CT (CPC>control and empty defect), histology/static histomorphometry (CPC>control and empty defect), fluorescence histomorphometry (CPC>control; all p<.05 for 3 and 9 months), and compressive strength measurements (CPC numerically higher than control; 102% for 3 months and 110% for 9 months).
This first-time systematic clinical assessment of a minimally invasive, ventrolateral, lumbar vertebroplasty model in aged, osteopenic sheep resulted in short operation times, rapid postoperative recovery, and high experimental reproducibility. This model represents an optimal basis for standardized evaluation of future studies on vertebral augmentation with resorbable and osteoconductive CPC.
BACKGROUND CONTEXT: Targeted delivery of osteoinductive bone morphogenetic Proteins (eg, GDF5) in bioresorbable calcium phosphate cement (CPC), potentially suitable for vertebroplasty and kyphoplasty of osteoporotic vertebral fractures, may be required to counteract augmented local bone catabolism and to support complete bone regeneration. The biologically optimized GDF5 Mutant BB-1 may represent an attractive drug candidate for this purpose.
PURPOSE: The aim of the current study was to test an injectable, poly (l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming CPC containing low-dose BB-1 in a sheep lumbar osteopenia model.
STUDY DESIGN/ SETTING: This is a prospective experimental animal study.
METHODS: Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and were filled with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages.
BACKGROUND CONTEXT:
Bioresorbable calcium phosphate cement (CPC) may be suitable for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures. However, additional targeted de-
livery of osteoinductive bone morphogenetic Proteins (BMPs) in the CPC may be required to counteract the augmented local bone catabolism and support complete bone regeneration.
PURPOSE:
This study aimed at testing an injectable, poly (l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing low-dose bone morphogenetic Protein BMP-2 in a sheep lumbar osteopenia model.
STUDY DESIGN/ SETTING:
This is a prospective experimental animal study.
METHODS:
Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and filled with fiber-reinforced CPC alone (L4; CPC+ fibers) or with CPC containing different dosages of BMP-2 (L5; CPC+ fibers + BMP-2; 1, 5, 100, and 500g BMP-2; n=5 or 6 each). The results were
compared with those of untouched controls (L1). Three and 9 months after the operation, structural and functional effects of the CPC (±BMP-2) were analyzed ex vivo by measuring
(1) bone Mineral density (BMD);
(2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography [micro-CT] and histomorphometry), trabecular thickness, and trabecular number;
(3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineral Apposition rate, and bone formation rate/bone surface;
(4) bone resorption, that is, eroded surface/bone surface; and
(5) compressive strength.
RESULTS:
Compared with untouched controls (L1), CPC+ fibers (L4) and/or CPC+ fibers + BMP-2(L5) significantly improved all parameters of bone formation, bone resorption, and bone structure.
These effects were observed at 3 and 9 months, but were less pronounced for some parameters at 9 months. Compared with CPC without BMP-2, additional significant effects of BMP-2 were demonstrated for bone structure (bone volume/total volume, trabecular thickness, trabecular number) and formation (osteoid surface/bone surface and mineralizing surface/bone surface), as well as for the compressive strength. The BMP-2 effects on bone Formation at 3 and 9 months were dose-dependent, with 5–100g as the optimal dosage.
CONCLUSIONS:
BMP-2 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. A single local dose as low as ≤100g BMP-2 was sufficient
to augment middle to long-term bone formation. The novel CPC+ BMP-2 may thus represent an alternative to the bioinert, supraphysiologically stiff polymethylmethacrylate cement presently used to treat osteoporotic vertebral fractures by vertebroplasty/kyphoplasty.
BACKGROUND CONTEXT:
Biodegradable calcium phosphate cement (CPC) represents a promising option for the surgical treatment of osteoporotic vertebral fractures. Because of augmented local bone catabolism, however, additional targeted delivery of bone morphogenetic proteins with the CPC may be needed to promote rapid and complete bone regeneration.
PURPOSE:
In the present study, an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing the bone morphogenetic Protein GDF5 was tested in a sheep lumbar osteopenia model.
STUDY DESIGN/SETTING:
This is a prospective experimental animal study
METHODS:
Defined bone defects (diameter 5 mm) were placed in aged, osteopenic female sheep.
Defects were treated with fiber-reinforced CPC alone (L4; CPC+ fibers) or with CPC containing different dosages of GDF5 (L5; CPC+ fibers + GDF5; 1, 5, 100, and 500g GDF5; n =
5 or 6 each).
The results were compared with those of untouched controls (L1). Three and 9 months postoperation, structural and functional effects of the CPC (±GDF5) were assessed ex vivo by measuring
(1) bone mineral density (BMD);
(2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography and histomorphometry), trabecular thickness, and trabecular number;
(3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralized surface/bone surface, mineral apposition rate, and bone formation rate/bone surface;
(4) bone resorption, that is, eroded surface/bone surface; and
(5) compressive strength.
RESULTS:
Compared with untouched controls (L1), both CPC+ fibers (L4) and CPC+ fibers + GDF5 (L5) numerically or significantly improved all parameters of bone formation, bone resorption, and bone structure. These significant effects were observed both at 3 and 9 months, but for some parameters they were less pronounced at 9 months. Compared with CPC without GDF5, additional significant effects of CPC with GDF5 were demonstrated for BMD and parameters of bone formation and structure (bone volume/total volume, trabecular thickness, and trabecular number, as well as mineralized surface/bone surface). The GDF5 effects were dose-dependent (predominantly in the 5–100g range) at 3 and 9 months.
CONCLUSIONS:
GDF5 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. The results indicated that a local dose as low as ≤100g
GDF5 may be sufficient to augment middle to long-term bone formation. The novel CPC+ GDF5 combination may thus qualify as an alternative to the bioinert, supraphysiologically stiff poly-(methyl methacrylate) cement currently applied for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures.
Injectable, brushite-forming calcium phosphate cements (CPC) show potential for bone replacement, but they exhibit low mechanical strength. This study tested a CPC reinforced with poly(l-lactide-co-glycolide) acid (PLGA) fibers in a minimally invasive, sheep lumbar vertebroplasty model.
The study aimed to test the in vivo biocompatibility and osteogenic potential of a PLGA fiber-reinforced, brushite-forming CPC in a sheep large animal model.