Properties of an In Vivo Fractured Poly(Methyl Methacrylate) Cranioplasty After 15 Years

Autor: Leander Dubois, Cees J. Kleverlaan, Cornelis J. Kleverlaan, Friso W. A. Hoefnagels, E. Nout, Niek de Jager, S.E.C.M. van de Vijfeijken, P.R.A.M. Depauw, A.G. Becking, Sebastian A. J. Zaat, W.P. Vandertop, Dan M.J. Milstein, T.J.A.G. Münker, Alfred G. Becking, Sophie E.C.M. van de Vijfeijken, William P. Vandertop, L.H.E. Karssemakers, Martijn Riool, Thomas J.J. Maal
Přispěvatelé: Graduate School, Oral and Maxillofacial Surgery, ACS - Microcirculation, Amsterdam Neuroscience - Neurovascular Disorders, Neurosurgery, Medical Microbiology and Infection Prevention, Maxillofacial Surgery (AMC), Dental Material Sciences
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: World neurosurgery, 123, e60-e68. Elsevier Inc.
CranioSafe Group 2019, ' Properties of an in vivo fractured poly(methyl methacrylate) cranioplasty after 15 years ', World neurosurgery, vol. 123, pp. e60-e68 . https://doi.org/10.1016/j.wneu.2018.11.026
van de Vijfeijken, S E C M, Münker, T J A G, de Jager, N, Vandertop, W P, Becking, A G, Kleverlaan, C J, Becking, A G, Dubois, L, Karssemakers, L H E, Milstein, D M J, van de Vijfeijken, S E C M, Depauw, P R A M, Hoefnagels, F W A, Vandertop, W P, Kleverlaan, C J, Münker, T J A G, Maal, T J J, Nout, E, Riool, M, Zaat, S A J & CranioSafe Group 2019, ' Properties of an In Vivo Fractured Poly(Methyl Methacrylate) Cranioplasty After 15 Years ', World Neurosurgery, vol. 123, pp. e60-e68 . https://doi.org/10.1016/j.wneu.2018.11.026
World Neurosurgery, 123, e60-e68. Elsevier Inc.
ISSN: 1878-8750
Popis: Background: In 2001, a 27-year-old man was diagnosed with a meningioma with skull bone involvement. A craniectomy was performed and a CMW-3 poly(methyl methacrylate) cranioplasty was manually manufactured to reconstruct the remaining cranial defect. In 2016, he complained about progressive neurologic impairment. A computed tomography scan revealed that the cranioplasty had fractured into 4 dislocated pieces. Removal was indicated, and during the same operation a polyetheretherketone patient-specific implant was inserted. Methods: The fractured cranioplasty was compared with freshly prepared CMW-3 specimens to determine whether the material properties had changed during 15 years in vivo. Gel permeation chromatography, microcomputed tomography, and flexural strength tests were performed. The fracture itself was analyzed using finite element analysis. Results: The polydispersity index and molecular weight were not significantly different for the fractured cranioplasty and CMW-3. The fractured cranioplasty contained a total porosity of 10.7%, fresh CMW-3 cured at atmospheric pressure contained 4.1%, and 0.06% when cured at 2.2 bar. The flexural strength of the CMW-3 cured at 2.2 bar was significantly higher than both the fractured cranioplasty and CMW-3 cured at atmospheric pressure. Finite element analysis showed stress of 12.2 MPa under a load of 100 N on a weak spot. Conclusions: This ex vivo study shows that CMW-3 after 15 years in vivo was not influenced in molecular weight or flexural strength. However, the design of the implant and the handling of the poly(methyl methacrylate) seem to be important factors to improve mechanical properties of cranial reconstructions.
Databáze: OpenAIRE
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