Effect of fabrication pressure on the fatigue performance of Cemex XL acrylic bone cement

During a cemented arthroplasty, the prepared polymerizing dough of acrylic bone cement is subjected to pressurization in a number of ways; first, during delivery into the freshly prepared bone bed, second, during packing in that bed (either digitally or with the aid of a mechanical device), and, third, during the insertion of the prosthesis. Only a few studies have reported on the influence of the level of pressurization experienced during these events (which, depending on the cementing technique used, has been put at between 8 and 273 kPa) on various properties of the cement. That was the focus of the present study, in which the fully reversed tension-compression (±15 MPa; 5 Hz) fatigue lives (expressed as number of cycles to fracture, Nf) of rectangular cross-sectioned “dog-bone” specimens (Type V, per ASTM D 638) fabricated from Cemex XL® cement, at pressure applied continuously to the cement dough during curing in the specimen mold, p=75,150, and 300 kPa, were determined. The Nf results were analyzed using the linearized transformation of the three-parameter Weibull relationship to obtain estimates of the Weibull mean, NWM, which was taken to be the index of fatigue performance of the specimen set. Over the range of p studied, NWM increased as p increased (for example, from 329,118 cycles when p was 75 kPa to 388,496 cycles when p was 300 kPa); however, the increase was not significant over any pair of p increment steps (Mann–Whitney U-test; α<0.05).