A finite element rheological model for polymethylmethacrylate flow: Analysis of the cement delivery in vertebroplasty

Abstract Polymethylmethacrylate (PMMA) is increasingly used in orthopaedics. Finite element (FE) modelling can play an important role in understanding the PMMA flow behaviour. However, FE models have not been used so far because conventional FE packages do not allow for the rheopectic and pseudoplastic behaviour of PMMA to be taken into consideration and because it requires multiple expertise to incorporate these behaviours into an FE package. The objectives of the present paper are to: (a) propose a rheological model that describes PMMA flow behaviour; (b) implement this model into ANSYS using FORTRAN; and (c) validate the implementation by comparing it with analytical solutions. After the validation showed good agreement, an FE model of PMMA delivery through an eight-gauge cannula was developed to examine the extra-vertebral flow conditions of vertebroplasty. The FE analysis showed a logarithmic increase of the injection pressure, where it almost doubled from 1.2 to 2.3 MPa over two minutes. This unanticipated non-linear increase is due to the highly non-uniform viscosity profile in the cannula. It can be concluded that: (a) the rheological model implemented in ANSYS can be used to analyse practical flow problems related to PMMA and (b) time and shear-rate effects of PMMA are crucial to estimate its flow behaviour accurately.

[1]  W R Krause,et al.  The viscosity of acrylic bone cements. , 1982, Journal of biomedical materials research.

[2]  M Bohner,et al.  Theoretical and experimental model to describe the injection of a polymethylmethacrylate cement into a porous structure. , 2003, Biomaterials.

[3]  T. Steffen,et al.  Injection biomechanics of bone cements used in vertebroplasty. , 2004, Bio-medical materials and engineering.

[4]  J. Theis,et al.  Fat Embolism and Acute Hypotension During Vertebroplasty: An Experimental Study in Sheep , 2002, Spine.

[5]  S. Belkoff,et al.  The Biomechanics of Vertebroplasty: The Effect of Cement Volume on Mechanical Behavior , 2001, Spine.

[6]  Mike Thelwall Review of "Web search: Public searching of the web, information and knowledge management series" by Amanda Spink and Bernhard J. Jansen, Kluwer academic publishers, Dordrecht, The Netherlands , 2006 .

[7]  S. Ferguson,et al.  Biomechanical Explanation of Adjacent Fractures Following Vertebroplasty [letter] * Dr Hirsch and colleagues respond: , 2003 .

[8]  W R Krause,et al.  Finite element modelling of polymethylmethacrylate flow through cancellous bone. , 1991, Journal of biomechanics.

[9]  N. Dunne,et al.  Flow characteristics of curing polymethyl methacrylate bone cement , 1998, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[10]  K. Ahrar,et al.  Percutaneous vertebroplasty and kyphoplasty for painful vertebral body fractures in cancer patients , 2003 .

[11]  P. Heini,et al.  The Use of a Side-Opening Injection Cannula in Vertebroplasty: A Technical Note , 2002, Spine.

[12]  J. Mathis,et al.  Vertebroplasty in Osteoporosis , 2002, Seminars in musculoskeletal radiology.

[13]  D. Farrar,et al.  Rheological properties of PMMA bone cements during curing. , 2001, Biomaterials.

[14]  P. Noble,et al.  Penetration of acrylic bone cements into cancellous bone. , 1983, Acta orthopaedica Scandinavica.

[15]  K. Lange,et al.  Preoperative and postoperative cognitive functioning in patients with frontal meningiomas. , 2003, Journal of neurosurgery.

[16]  C. Heisel,et al.  Influence of cement viscosity on cement interdigitation and venous fat content under in vivo conditions , 2002, Acta orthopaedica Scandinavica.

[17]  J. Mathis Vertebroplasty for vertebral fractures with intravertebral clefts. , 2002, AJNR. American journal of neuroradiology.

[18]  J. Nemes,et al.  Biomechanical explanation of adjacent fractures following vertebroplasty. , 2003, Radiology.

[19]  M Bohner,et al.  How to determine the permeability for cement infiltration of osteoporotic cancellous bone. , 2003, Medical engineering & physics.

[20]  G. Baroud,et al.  Experimental and theoretical investigation of directional permeability of human vertebral cancellous bone for cement infiltration , 2004 .