Strength of the cement-bone interface.

The fixation of total joint components to bone using acrylic bone cement is by the penetration of the cement into the microstructure of cancellous bone to achieve a mechanical interlock. It has been shown that the method of cement application and the preparation of the cancellous surface significantly affects both the tensile and shear strengths of the cement-bone interface. Doughy cement finger-packed on an uncleaned surface resulted in a very low interface strength compared to a low-viscosity cement made to penetrate a cleaned bone surface. Maximum strengths were achieved for cancellous bone cleaned by using either a high-intensity water lavage or a polyethylene brush and by facilitating penetration of the cement for distances of 5 to 10 mm into the bone.