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Literature Review of the Clinical Evidence Situation of Bone Cements

Pilz V* and Hanstein T

Bone cements based on Polymethyl methacrylate (PMMA) are essential products in orthopaedic surgery being popularized in the early 1960s, already. On the basis of its use over several decades, Arthroplasty registries analysed long-term results demonstrating differences in terms of revision risks for different bone cement brands. In this study, we aimed to investigate the evidence situation in regards to different bone cements of the most used brands in joint replacement. We performed a literature review by two reviewers independently to identify primary and secondary articles that described and evaluated the use of bone cement in surgical procedures, including orthopaedic, trauma and neurosurgery. The level of evidence was then graded using the Journal of Bone and Joint Surgery (JBJS) hierarchy. Out of 1.424 articles identified, 178 articles met the inclusion criteria. The bone cement Palacos manufactured by Heraeus Medical sums up to the best studied bone cement incorporating 136 clinical studies which are furthermore dating back the longest time period including 8.990 patients. The average quality of included studies was best for bone cements manufactured by Tecres and Smith & Nephew.