The authors submit their initial experience with the use of bone cement with methotrexate in the treatment of primary and secondary malignities of bones. As a basis they use the analogy of using bone cement with gentamycin the molecular structure of which is similar to that of methtrexate. In the experimental part of the work in vitro evidence was provided of methotrexate stability when exposed to heat or oxidation; and the kinetics of its release from pores of bone cement were revealed. In experimental dogs the effect of cement with methotrexate on neighbouring bone was investigated in the early period in the immediate vicinity necrosis of the trabeculae was found, during the late period healing processes. The clinical use of bone cement with methotrexate was started in 1986. In 17 surviving patients only in one case local progression of a tumour in the vicinity of cement with methotrexate was found. The aim of the work is to find a possible local treatment of bone malignities, in particular metastatic ones, which will be not only an emergency solution but will extend our therapeutic possibilities.

• MeSH
• kosti a kostní tkáň metabolismus   MeSH
• kostní cementy * MeSH
• lidé MeSH
• methotrexát aplikace a dávkování   farmakokinetika   terapeutické užití   MeSH
• nádory kostí farmakoterapie   chirurgie   MeSH
• psi MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• psi MeSH
• zvířata MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• kostní cementy * MeSH
• methotrexát MeSH

PURPOSE: The cement augmentation of a conventional anterior screw fixation in type II odontoid process fractures for elderly patients significantly increased stiffness and load to failure under anterior-posterior load in comparison with non-augmented fixation. The amount and quality of bone cement are usually taken ad hoc in clinical practise. In this study, we wanted to clarify the role of bone cement amount and its quality to the stiffness of odontoid and vertebrae body junction. METHODS: Finite-element method was used to achieve different scenarios of cement augmentation. For all models, an initial stiffness was calculated. Model (1) the intact vertebrae were virtually potted into a polymethylmethacrylate base via the posterior vertebral arches. A V-shaped punch was used for loading the odontoid in an anterior-posterior direction. (2) The odontoid fracture type IIa (Anderson-D'Alonzo classification) was achieved by virtual transverse osteotomy. Anterior screw fixation was virtually performed by putting self-drilling titanium alloy 3.5 mm diameter anterior cannulated lag screw with a 12 mm thread into the inspected vertebrae. A V-shaped punch was used for loading the odontoid in an anterior-posterior direction. The vertebrae body was assumed to be non-cemented and cemented with different volume. RESULTS: The mean cement volume was lowest for body base filling with 0.47 ± 0.03 ml. The standard body filling corresponds to 0.95 ± 0.15 ml. The largest volume corresponds to 1.62 ± 0.12 ml in the presence of cement leakage. The initial stiffness of the intact C2 vertebrae was taken as the reference value. The mean initial stiffness for non-porous cement (E = 3000 MPa) increased linearly (R2 = 0.98). The lowest stiffness (123.3 ± 5.8 N/mm) was measured in the intact C2 vertebrae. However, the highest stiffness (165.2 ± 5.2 N/mm) was measured when cement leakage out of the odontoid peg occurred. The mean initial stiffness of the base-only cemented group was 147.2 ± 8.4 N/mm compared with 157.9 ± 6.6 N/mm for the base and body cemented group. This difference was statistically significant (p < 0.0061). The mean initial stiffness for porous cement (E = 500 MPa) remains constant. Therefore, there is no difference between cemented and non-cemented junction. This difference was not statistically significant (p < 0.18). CONCLUSION: The present study showed that the low porous cement was able to significantly influence the stiffness of the augmented odontoid screw fixation in vitro, although further in vivo clinical studies should be undertaken. Our results suggest that only a small amount of non-porous cement is needed to restore stiffness at least to its pre-fracture level and this can be achieved with the injection of 0.7-1.2 ml of cement. These slides can be retrieved under Electronic Supplementary Material.

• Klíčová slova
• Bone cement, Finite element, Fracture, Odontoid, Spine,
• MeSH
• dens axis * diagnostické zobrazování   zranění   chirurgie   MeSH
• fraktury páteře * diagnostické zobrazování   chirurgie   MeSH
• kostní cementy terapeutické užití   MeSH
• kostní šrouby MeSH
• lidé MeSH
• senioři MeSH
• vnitřní fixace fraktury MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• kostní cementy MeSH

PURPOSE: Antibiotic-loaded polymethylmethacrylate-based bone cement has been implemented in orthopaedics to cope with implant-related infections associated with the formation of bacterial biofilms. In the context of emerging bacterial resistance to current antibiotics, we examined the efficacy of short antimicrobial peptide-loaded bone cement in inhibiting bacterial adhesion and consequent biofilm formation on its surface. METHODOLOGY: The ability of α-helical antimicrobial peptides composed of 12 amino acid residues to prevent bacterial biofilm [methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Pseudomonas aeruginosa and Escherichia coli] formation on the surface of model implants made from polymethylmethacrylate-based bone cement was evaluated by colony-forming unit (c.f.u.) counting of bacteria released by sonication from the biofilms formed on their surfaces. The biofilms on model implant surfaces were also visualized by light microscopy after staining with tetrazolium dye (MTT) and by scanning electron microscopy. RESULTS: When incorporated in the implants, these peptides caused a mean reduction in the number of bacterial cells attached to implants' surfaces (by five orders of magnitude), and 88 % of these implants showed no bacterial adhesion after being exposed to growth media containing various bacteria. CONCLUSION: The results showed that the antibiofilm activity of these peptides was comparable to that of the antibiotics, but the peptides exhibited broader specificity than the antibiotics. Given the rapid development of antibiotic resistance, antimicrobial peptides show promise as a substitute for antibiotics for loading into bone cements.

• Klíčová slova
• antibiotics, antimicrobial peptides, biofilm, implant-related infections, polymethylmethacrylate bone cement,
• MeSH
• antibakteriální látky farmakologie   MeSH
• antiinfekční látky farmakologie   MeSH
• bakteriální adheze účinky léků   MeSH
• biofilmy účinky léků   růst a vývoj   MeSH
• kostní cementy MeSH
• methicilin rezistentní Staphylococcus aureus účinky léků   růst a vývoj   MeSH
• mikrobiální testy citlivosti MeSH
• peptidy chemická syntéza   farmakologie   MeSH
• polymethylmethakrylát MeSH
• protézy a implantáty mikrobiologie   MeSH
• Pseudomonas aeruginosa účinky léků   růst a vývoj   MeSH
• Staphylococcus epidermidis účinky léků   růst a vývoj   MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antibakteriální látky MeSH
• antiinfekční látky MeSH
• kostní cementy MeSH
• peptidy MeSH
• polymethylmethakrylát MeSH

OBJECTIVES: The purpose of this study was to evaluate the in vitro sealing ability of three repair materials. Mineral trioxide aggregate (MTA; Group A), calcium phosphate cement (CPC; Group B), and light cured glass ionomer cement (GIC; Group C) when used to repair the perforation created in the pulpal floor of fifty extracted human permanent molars. MATERIALS AND METHODS: Preparation of access openings and furcation perforations were done, and the teeth divided into five experimental groups (A, B, C) including two controls (D, E) with ten samples in each group randomly. Following the repair procedure, the pulp chambers and access openings were filled with composite resin and immersed in 2% methylene blue solution for 48 hours. The teeth were sectioned longitudinally and the linear dye penetration measured under a stereomicroscope. RESULTS: The comparison of the linear length of micro-leakage (mm) among the experimental groups revealed no significant difference (p = 0.332). On calculating the percentage of depth of leakage to the total length of the perforation, it was observed that the mean leakage was 35.5% in Group A, 53.6% in Group B and the highest, 87.5% in Group C. The mean of leakage percentage was statistically significant by Kruskal-Wallis test (p = 0.003). The results indicated that the dye penetration used as furcation perforation repair material was least with mineral trioxide aggregate. Comparing the depth of penetration of dye, 50% of the Group A samples showed less than 25% of depth penetration. While 40% of Group B cases had more than 50% dye penetration. In our study, all Group C teeth had > or = 50% dye penetration. CONCLUSIONS: The present study indicated that GIC had the greatest dye penetration followed by CPC and MTA. Mineral trioxide aggregate and calcium phosphate cement had comparatively better sealing ability than glass ionomer cement.

• MeSH
• fixní kombinace léků MeSH
• fosforečnany vápenaté terapeutické užití   MeSH
• lidé MeSH
• moláry zranění   MeSH
• netěsnost výplní etiologie   prevence a kontrola   MeSH
• obnažení zubních kořenů etiologie   terapie   MeSH
• oxidy terapeutické užití   MeSH
• silikáty terapeutické užití   MeSH
• skloionomerní cementy terapeutické užití   MeSH
• sloučeniny hliníku terapeutické užití   MeSH
• sloučeniny vápníku terapeutické užití   MeSH
• techniky in vitro MeSH
• zubní dřeň zranění   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• calcium phosphate MeSH Prohlížeč
• fixní kombinace léků MeSH
• fosforečnany vápenaté MeSH
• mineral trioxide aggregate MeSH Prohlížeč
• oxidy MeSH
• silikáty MeSH
• skloionomerní cementy MeSH
• sloučeniny hliníku MeSH
• sloučeniny vápníku MeSH

Polymethylmethacrylate (PMMA) bone cement mixed with antibiotics is used in orthopedic surgery to cope with implant-related infections which are typically associated with the formation of bacterial biofilms. Taking into account the growing bacterial resistance to current antibiotics, we examined here the efficacy of a selected antimicrobial peptide (AMP) mixed into the bone cement to inhibit bacterial adhesion and the consequent biofilm formation on its surface. In particular, we followed the formation of bacterial biofilms of methicillin-resistant Staphylococcus aureus (MRSA) on implants made from PMMA bone cement loaded with AMP composed of 12 amino acid residues. This was evaluated by CFU counting of bacteria released by sonication from the biofilms formed on their surfaces after these implants were retrieved from the infected murine femoral canals. The AMP loaded in these model implants prevented adhesion of MRSA and the subsequent formation of MRSA biofilm on the surfaces of more than 80% of these implants, whereas biofilms did form on control implants made from the plain cement. The results of our experiments performed in the murine femoral canal indicate the potential for this murine osteomyelitis model to mimic actual operations in orthopedics.

• Klíčová slova
• Antimicrobial peptide, Bacterial biofilm, Implant-related infections, Murine model, PMMA implants, Polymethylmethacrylate bone cement,
• MeSH
• aminokyseliny MeSH
• antibakteriální látky farmakologie   terapeutické užití   MeSH
• antimikrobiální peptidy MeSH
• biofilmy MeSH
• kostní cementy MeSH
• methicilin rezistentní Staphylococcus aureus * MeSH
• modely nemocí na zvířatech MeSH
• myši MeSH
• ortopedické výkony * MeSH
• polymethylmethakrylát chemie   MeSH
• zvířata MeSH
• Check Tag
• myši MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• aminokyseliny MeSH
• antibakteriální látky MeSH
• antimikrobiální peptidy MeSH
• kostní cementy MeSH
• polymethylmethakrylát MeSH

In the paper lying before the authors estimate changes of pH-values of the Calcium hydroxide (Calxyd) after contact with a zinc oxide phosphate cement (Adhesor), a polyacrylate cement (Adhesor-Carboxy) and a zinc oxide eugenol cement (Caryosan). The last shoved to be best qualified for over capping of pasty preparation with calcium hydroxide.

• MeSH
• analýza rozptylu MeSH
• hydroxid vápenatý chemie   MeSH
• koncentrace vodíkových iontů MeSH
• lidé MeSH
• polykarboxylátový cement chemie   MeSH
• překrytí zubní dřeně * MeSH
• sekundární dentin MeSH
• zinkfosfátový cement chemie   MeSH
• zinkoxid-eugenolový cement chemie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• srovnávací studie MeSH
• Názvy látek
• hydroxid vápenatý MeSH
• polykarboxylátový cement MeSH
• zinkfosfátový cement MeSH
• zinkoxid-eugenolový cement MeSH

PURPOSE OF THE STUDY The aim of this study is to describe a new technique for cement augmentation of primary anterior cervical screw fixation in the sub-axial cervical spine. MATERIAL AND METHODS Seven patients underwent anterior cervical spine surgery for trauma (two) or tumor infiltration (five) between 2008 and 2015. The tumor cases underwent corpectomy and anterior plating, with the trauma cases undergoing anterior cervical decompression and fusion using iliac crest bone graft. All surgeries were performed through the standard anterior approach. 0.2-0.25 ml of Kyphon cement were introduced into the screw holes before the screws were locked into the plate of the anterior construct. Karnofsky Index, Spinal Instability Neoplastic score (SINS) were calculated and radiographic follow-up performed. RESULTS Median follow-up was 7 months (range 7 weeks-39 months). There were no complications from cement leakage or construct failure during the follow-up period. There were no wound infections or approach-related complications. We did not have to re-operate on any patient, cervical spine remained stable until the end of follow up. DISCUSSION Until now a limited number of papers on cement augmentation of cervical spine mainly dealt with revision surgeries, when cement was used as rescue technique to re-establish stability of previous fixation or cement augmentation was performed in form of vertebroplasty following plate fixation. Our technique intends to prevent revision surgeries and to anchor all screws in holes which are evenly filled with bone cement. CONCLUSIONS This technique of cement augmentation is a useful adjunct in those few patients where a secondary posterior surgery would be high-risk due to the general health of the patient, or when life expectancy is limited. We have shown that anterior alone reconstruction of the cervical spine with cement augmentation of screws did provide sufficient and sufficiently long stability of the cervical spine which prevented catastrophic collapse and quadriplegia in patients in poor general condition. Key words: cement augmentation, cervical spine, corpectomy, tumor, stabilization, fusion.

• MeSH
• cementování metody   MeSH
• chirurgická dekomprese metody   MeSH
• fraktury páteře chirurgie   MeSH
• fúze páteře přístrojové vybavení   metody   MeSH
• kostní cementy * MeSH
• kostní destičky * MeSH
• kostní šrouby MeSH
• krční obratle zranění   chirurgie   MeSH
• lidé MeSH
• nádory páteře chirurgie   MeSH
• následné studie MeSH
• reoperace metody   MeSH
• transplantace kostí metody   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kostní cementy * MeSH

Femoral bone lysis in total hip arthroplasty is thought to be primarily due to polyethylene or metal debris arising from the femoral or acetabular components. The debris appears to gradually seep into the cement/ bone interface, eventually generating the chemical reaction that produces lysis.We experimented with a surgical technique that attempts to construct a proximal bony barrier preventing migration of debris. Following the injection of the acrylic cement and the insertion of the femoral component, but prior to complete polymerization of the cement, bone chips are pressed over the cement, in contact with the viable femoral cortex. The bone chips become rigidly fixed; probably regain viability from the femoral cortex, and seal the proximal femur. In this manner, debris cannot travel into the femoral canal. Although we do not have anatomical evidence that a viable bony seal has formed the absence of lysis and bone/cement radiolucent lines over a period of time ranging from three to fourteen years suggests the permanent presence of a physiological barrier. Attempts to identify the permanency of the bony seal by means of CT scans proved inconclusive. Key words: total hips, lysis, femoral lysis, cortical graft.

• MeSH
• hlavice femuru * MeSH
• kostní cementy MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu škodlivé účinky   metody   MeSH
• následné studie MeSH
• osteolýza etiologie   prevence a kontrola   MeSH
• polymethylmethakrylát aplikace a dávkování   MeSH
• selhání protézy MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• transplantace kostí MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kostní cementy MeSH
• polymethylmethakrylát MeSH

• Klíčová slova
• COPPER/metabolism *, DENTAL MATERIALS *,
• MeSH
• ionty * MeSH
• lidé MeSH
• měď metabolismus   MeSH
• skloionomerní cementy * MeSH
• zubní cement (tkáň) * MeSH
• zubní cementy * MeSH
• zubní dřeň * MeSH
• zubní materiály * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• ionty * MeSH
• měď MeSH
• skloionomerní cementy * MeSH
• zubní cementy * MeSH
• zubní materiály * MeSH

BACKGROUND: In reoperation of femoral prostheses, there is a higher percentage of complications associated with the extraction of bone cement from the femoral channel, which is technically and time consumingly tedious. Shockwaves have been used in medicine for years, particularly in urology for the destruction of concretions and orthopaedics, as a method of treating pain in patients with calcifying enthesopathy. MATERIALS AND METHODS: We studied the use of shockwaves generated by a new source based on the multichannel discharge principle in facilitating extraction of bone cement. Femurs of experimental minipigs were chosen as models. We implanted bone cement into the femoral channel and subsequently applied shockwaves. We then measured the force necessary to extract bone cement. RESULTS: The results indicate that the force necessary for extracting cement was consistently statistically significantly lower in the group treated with multichannel discharge shockwaves compared to that for the controls.

• Klíčová slova
• Shockwave, bone cement extractions, surgical revision,
• MeSH
• femur chirurgie   MeSH
• kosti a kostní tkáň * MeSH
• kostní cementy * MeSH
• lidé MeSH
• miniaturní prasata MeSH
• modely u zvířat MeSH
• prasata MeSH
• protézy a implantáty MeSH
• rázové vlny s vysokou energií * MeSH
• reoperace metody   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kostní cementy * MeSH