Thermal properties of polymethyl methacrylate vary depending on brand and type

Polymethyl methacrylate (PMMA) is commonly used in orthopedic surgery and has several applications, most often for fixation of arthroplasty components. While its overall safety and tolerance are well described, less is known regarding the thermal properties of PMMA as it sets from a liquid to solid state, as well as the potential for osseous thermal necrosis. This study addresses potential variations in the setting time and maximum temperature of PMMA formulations in common use and explores the potential clinical implications of this variability. Seven commercially available formulations of PMMA that varied by brand and/or viscosity were obtained and prepared according to manufacturer's instructions. Peak temperature and duration were measured in controlled settings for each type and compared to previously described thresholds for thermal bone necrosis. Depuy SmartSet (HV), Zimmer Palacos R (HV), and Zimmer Palacos (LV) exceeded the 56°C threshold reported to potentially induce immediate osseous thermal necrosis. Additionally, Biomet Cobalt (MV) and Stryker Simplex P (MV) had lower peak temperatures but exceeded thermal necrosis thresholds due to curing duration. The lowest peak temperature was observed for Smith & Nephew Versabond (MV), which was significantly lower than all types except Depuy SmartSet (MV). Setting time was not significantly different among groups. There are significant differences in the thermal properties of PMMA formulations in current use. Selection of specific PMMA formulations represents an additional route of procedural optimization depending on the needs of the treating surgeon.