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A comparative study of the effect of hydrogen peroxide versus normal saline on the strength of the bone-cement

S R Guerin1, R MacNiochaill, P O'Reilly

  • 1Trinity Centre for Bioengineering, Department of Mechanical and Manufacturing Engineering, Trinity College, Dublin, Ireland.

Insights

Hydrogen peroxide, used as a haemostatic agent in arthroplasty, does not negatively impact the mechanical strength of bone-cement interfaces. This study found no significant differences when comparing hydrogen peroxide to saline treatments.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Surgical Hemostasis

Background:

  • Hydrogen peroxide is a common effervescent hemostatic agent in arthroplasty.
  • Recent studies suggest potential adverse effects of hydrogen peroxide on polymethyl methacrylate (PMMA) properties.

Purpose of the Study:

  • To evaluate the mechanical integrity of the bone-cement interface after using hydrogen peroxide as a hemostatic agent in an experimental model.
  • To determine if hydrogen peroxide adversely affects cement-bone bond strength compared to saline.

Main Methods:

  • Cancellous bone samples were treated with either 3% hydrogen peroxide or saline-soaked swabs.
  • Bone-cement constructs were created using Palacos or Simplex cement.
  • Samples were subjected to torsional shear and tensile testing to failure.

Main Results:

  • No significant differences in mean torque to failure were observed between hydrogen peroxide and saline groups for both Palacos (p=0.31) and Simplex (p=0.71) cements.
  • No significant differences in mean tension load to failure were found between hydrogen peroxide and saline groups for both Palacos (p=0.79) and Simplex (p=0.23) cements.

Conclusions:

  • The use of hydrogen peroxide as an effervescent hemostatic agent does not compromise the mechanical integrity of the bone-cement interface.
  • Clinical application of hydrogen peroxide in arthroplasty appears safe regarding bone-cement bond strength.

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