Bone Cement

Osteomyelitis of the hand

“…However, in more severe or chronic cases and with larger bony defects, it may be more appropriate to stabilize the skeleton with an external fixator and perform bony reconstruction at a second stage (at least 4–6 weeks later) (Barbieri and Freeland, 1998; Freeland and Senter, 1989; Reilly et al, 1997). In the interim, antibiotic impregnated polymethyl methacrylate cement can be used, either fashioned into beads (which are thought to release more antibiotic due to their increased surface area) or a tubular spacer (providing potential mechanical stability) (Duffy and Shafritz, 2011; Freeland and Senter, 1989; Proubasta et al, 2004; Reilly et al, 1997). As well as delivering antibiotics locally, it acts as a physical block preventing fibrous tissue invasion, and over a period of 6–8 weeks induces a surrounding membrane.…”

Local adjuvants for benign aggressive bone tumors

“…Antibiotics have been mixed with PMMA to locally treat infection, 61 and chemotherapy is a common adjunctive treatment to many cancers. The local use of chemotherapy for benign aggressive bone tumors has not yet been widely reported.…”

“…61,79 In addition to playing a structural role in tumor management, various studies have shown that PMMA reduces recurrence to 7.9--27.8%. It is used as a packing material after curettage in the treatment of benign aggressive bone tumors and when prostheses are employed after wide excision requiring the removal of large portions of bone and joint to provide immediate mechanical stability.…”

Ambient theatre temperature and cement setting time in total knee arthroplasty

“…The role of cement in total knee arthroplasty (TKA) is to maximize surface contact at the bone–prosthesis interface and direct force evenly across it; acting as grout, it eliminates unwanted movement of the implant that could lead to aseptic loosening and joint failure . To accomplish this, cement needs to be easily manipulated by the surgeon during application, cure in a predictable fashion at temperatures acceptable to patients and staff and rapidly develop strength sufficient to withstand early rehabilitation protocols.…”

“…The role of cement in total knee arthroplasty (TKA) is to maximize surface contact at the bone-prosthesis interface and direct force evenly across it; acting as grout, it eliminates unwanted movement of the implant that could lead to aseptic loosening and joint failure. 1,2 To accomplish this, cement needs to be easily manipulated by the surgeon during application, cure in a predictable fashion at temperatures acceptable to patients and staff and rapidly develop strength sufficient to withstand early rehabilitation protocols. Over time, surgical technique has evolved in response to evidence supporting novel means of controlling biophysical properties of cement, most notably vacuum mixing of prechilled cement and retrograde pressurized application using a cement 'gun' which results in reduced porosity, increased compressive strength and improved intrusion of cement into bony contours.…”