Penetration and flow of acrylic bone cement

Fixation of prosthetic joint components into bone is influenced by the degree of mechanical interdigitation of the acrylic into cancellous interstices. The rheology of polymerizing polymethylmethacrylate was studied by pressurizing acrylic bone cement with a piston apparatus to produce flow into cylindrical cavities one to 3 mm in diameter. The acrylic penetration per unit of applied pressure increased with increasing cavity diameter. This suggests that greater penetration should occur in cancellous bone containing larger interstitial cavities. More than one-half (64 %) of the filling observed in our experiments took place within the first second of pressure application. Short duration, high level pressure pulses are the most effective means to achieve maximum penetration. Clinically, this is accomplished by vigorous finger packing. The cement should be pressurized as early as possible within the rasped cavity (immediately after dough stage if possible). The depth of penetration for 4-minute pressurization averaged three times that for 6 1/2-minute pressurization for the range of hole sizes and pressure levels tested.