Thermal manipulation of bone cement.
Many factors affect the rate of polymerization of polymethylmethacrylate (PMMA) and, therefore, the working time of bone cement. Surgeons may control some factors, but not all. A surgeon may change the temperature of the powder and the monomer, whereas the temperature and relative humidity of the operating room are more difficult to alter. The temperature of the mixing vessels may also be controlled. However, a surgeon has no control over the industrial mixture of the components of the bone cement, which can vary considerably from batch to batch. This article reviews the effect of temperature of cement mixtures on the working time of the cement, the interfacial strength of the cement-metal interface as well as the cement-bone interface, and tissue viability and cellular change at the bone-cement interface.
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