Differences in bone-cement porosity by vacuum mixing, centrifugation, and hand mixing

The mean pore size and percent porosity of vacuum-mixed cement were compared with centrifuged cement and cement hand mixed by skilled specialized operating room technicians. Centrifuged cement samples had the smallest mean pore size when compared with vacuum-mixed specimens. The mean pore size for the hand-mixed specimens was intermediate and not significantly different from the other 2 mixing techniques. Results were reversed, however, for mean percent porosity. Centrifuged cement had the highest percent porosity; vacuum-mixed cement, the lowest; and hand-mixed cement, intermediate. The porosity of vacuum-mixed Simplex P (Howmedica, Rutherford, NJ) bone-cement was similar from the initial to the remnant cement extruded from the cement gun. There was no reduced cement porosity with vacuum mixing or centrifugation as anticipated. Reversion to hand mixing by highly skilled technicians could result in a significant cost savings without negative effects on cement porosity.