The Role of Cement Viscosity on Cement-Bone Apposition and Strength: An In Vitro Model with Medullary Bleeding

We compared the mechanical and morphological characteristics of cement-bone structures created with either standard-or low-viscosity cement using a human cadaver model that simulated intramedullary bleeding. The goal is to determine if the viscosity of the cement would affect the strength of the cement-bone interface and the degree of apposition between the cement and bone. The tensile strength of cement-bone constructs with standard-viscosity cement (2.42 ± 1.55 MPa) was 21% stronger than with low-viscosity cement (2.00 ± 1.51 MPa, P = .034). Cement-bone apposition was positively correlated (r² = 0.29, P <. 0001) with the strength of the interface. There was 15% greater apposition between cement and bone (P = .036) for standard-viscosity cement. Low-viscosity cement may be less effective in displacing bone marrow and in preventing hemodynamic backflow, resulting in less apposition and a weaker interface.