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Does vacuum mixing affect diameter shrinkage of a PMMA cement mantle during in vitro cemented acetabulum implantation?

Lookup NU author(s): Dr Alex Boote, Professor David Deehan, Dr Kenneth RankinORCiD, Dr David Swailes, Dr Philip Hyde



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Radiolucent lines on immediate postoperative cemented acetabular component radiographs between the PMMA bone cement mantle and bone are an indicator of an increased risk of early loosening. The cause of these lines has yet to be identified. Thermal and chemical necrosis, fluid interposition and cement shrinkage have all been suggested in the literature. The aim of the study reported here was to take an engineering approach – eliminating confounding variables present during surgery – to quantify the size of the interstice created by cement shrinkage when a 50 mm diameter flanged acetabular cup is implanted in a model acetabulum with a 52 mm hemispherical bore under controlled conditions using vacuum and non-vacuum mixed cement. Irrespective of the mixing method used, a significant interstice was created between the bone cement and the mock acetabulum. When the cement was mixed under vacuum the interstice created between the mock acetabulum and the cement mantle was 0.60 mm ± 0.09 mm; when the cement was mixed under non-vacuum conditions the interstice created was 0.39 mm ± 0.15 mm. Possible explanations for radiolucent lines are discussed.

Publication metadata

Author(s): Boote AT, Bigsby RJ, Deehan DJ, Rankin KS, Swailes DC, Hyde PJ

Publication type: Article

Publication status: Published

Journal: Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine

Year: 2020

Volume: 235

Issue: 2

Pages: 133-140

Print publication date: 01/02/2021

Online publication date: 15/10/2020

Acceptance date: 03/09/2020

Date deposited: 16/10/2020

ISSN (print): 0954-4119

ISSN (electronic): 2041-3033

Publisher: Sage Publications Ltd.


DOI: 10.1177/0954411920964023


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