Orthopaedic bone cement: do we know what we are using?

J Bone Joint Surg Br. 2008 May;90(5):643-7. doi: 10.1302/0301-620X.90B5.19803.

Abstract

Bone cements produced by different manufacturers vary in their mechanical properties and antibiotic elution characteristics. Small changes in the formulation of a bone cement, which may not be apparent to surgeons, can also affect these properties. The supplier of Palacos bone cement with added gentamicin changed in 2005. We carried out a study to examine the mechanical characteristics and antibiotic elution of Schering-Plough Palacos, Heraeus Palacos and Depuy CMW Smartset bone cements. Both Heraeus Palacos and Smartset bone cements performed significantly better than Schering-Plough Palacos in terms of mechanical characteristics, with and without additional vancomycin (p < 0.001). All cements show a deterioration in flexural strength with increasing addition of vancomycin, albeit staying above ISO minimum levels. Both Heraeus Palacos and Smartset elute significantly more gentamicin cumulatively than Schering-Plough Palacos. Smartset elutes significantly more vancomycin cumulatively than Heraeus Palacos. The improved antibiotic elution characteristics of Smartset and Heraeus Palacos are not associated with a deterioration in mechanical properties. Although marketed as the 'original' Palacos, Heraeus Palacos has significantly altered mechanical and antibiotic elution characteristics compared with the most commonly-used previous version.

MeSH terms

  • Anti-Bacterial Agents / analysis*
  • Arthroplasty, Replacement
  • Bone Cements / analysis*
  • Gentamicins / analysis
  • Hardness Tests
  • Humans
  • Materials Testing*
  • Polymethyl Methacrylate / analysis*
  • Statistics as Topic
  • Stress, Mechanical*
  • Vancomycin / analysis
  • Weight-Bearing / physiology*

Substances

  • Anti-Bacterial Agents
  • Bone Cements
  • Gentamicins
  • Vancomycin
  • Polymethyl Methacrylate