Tensile strength of the cement-bone interface depends on the amount of bone interdigitated with PMMA cement

Abstract

An experimental investigation was performed to (1) determine the general mechanical behavior and in particular, the post-yield behavior of the cement-bone interface under tensile loading, (2) determine where interface failure occurs, and (3) determine if the mechanical properties of the interface could be related to the density of bone at the interface and/or the amount of cement-bone interdigitation. Seventy-one cement-bone test specimens were machined from human proximal femurs that had been broached and cemented using contemporary cementing techniques. The amount of cement-bone interdigitation was documented and the quantitative computed tomography equivalent mineral density (QCT density) of the bone with cement was measured. Specimens were loaded to failure in tension under displacement control and exhibited linear elastic behavior with some reduction in stiffness until the peak tensile stress was reached (1.28 +/- 0.79 MPa). A substantial amount of strain softening (negative tangent stiffness) with an exponential-type decay was found after the peak stress and continued until there was complete debonding of the specimens (at 0.93 +/- 0.44 mm displacement). Interfacial failure most often occurred at the extent of cement penetration into the bone (56% of specimens) or with small spicules of cement left in the bone (38% of specimens). The results showed that the post-yield tensile behavior contributes substantially to the energy required to cause failure of the cement-bone interface, but the post-yield behavior was not well correlated with the amount of interdigitation or density of bone. Linear regression analysis revealed a moderate (r2 = 0.499, p < 0.0001) positive relationship between the tensile strength of the cement-bone interface and the quantity of bone interdigitated with the cement.