Bone injury caused by curing bone cement. A vital microscopic study in the rabbit tibia.

The tissue trauma caused by leakage of monomer from curing bone cement was studied in rabbit bone. With a chamber method it was possible to study by intravital microscopy the tissue response in the same animal from the time of cement application to as long as 350 days afterward. The immediate monomer effects were mainly vascular: blood flow disturbances, blood flow standstill, and intravascular hemolysis. The most striking finding was that the extent of vascular disturbance was related to the type of tissue afflicted: In fatty marrow the effects were widespread, and in bone or fibrous tissue they were very limited. This is interpreted to reflect the affinity of the monomer to lipid-rich tissues. Follow-up observations showed marked resorption of marrow fat cells during the first weeks after injury, whereas very little bone was resorbed.