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Bone cement


Synthetic, self-curing organic or inorganic material used
to fill up a cavity or to create a mechanical fixation.

Note 1: In situ self-curing can be the source of released reagents
that can cause local and/or systemic toxicity as in the case of the
monomer released from methacrylics-based bone cement used in
orthopedic surgery.

Note 2: In dentistry, polymer-based cements are also used as fillers
of cavities. They are generally cured photochemically using UV radiation
in contrast to bone cements.

Bone cements have been used very successfully to anchor artificial joints (hip joints, knee joints, shoulder and elbow joints) for more than half a century. Artificial joints (referred to as prostheses) are anchored with bone cement. The bone cement fills the free space between the prosthesis and the bone and plays the important role of an elastic zone. This is necessary because the human hip is acted on by approximately 10-12 times the body weight and therefore the bone cement must absorb the forces acting on the hips to ensure that the artificial implant remains in place over the long term.

Bone cement chemically is nothing more than Plexiglas (i.e. polymethyl methacrylate or PMMA). PMMA was used clinically for the first time in the 1940s in plastic surgery to close gaps in the skull. Comprehensive clinical tests of the compatibility of bone cements with the body were conducted before their use in surgery. The excellent tissue compatibility of PMMA allowed bone cements to be used for anchorage of head prostheses in the 1950s.

Today several million procedures of this type are conducted every year all over the world and more than half of them routinely use bone cements - and the proportion is increasing. Bone cement is considered a reliable anchorage material with its ease of use in clinical practice and particularly because of its proven long survival rate with cemented-in prostheses. Hip and knee registers for artificial joint replacements such as those in Sweden and Norway clearly demonstrate the advantages of cemented-in anchorage. A similar register for endoprosthesis was introduced in Germany in 2010.


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