Loosening is the dominant long-term problem facing joint replacement surgeons and patients. A probable cause of endoprosthesis loosening is the strain singularity at the material interfaces. The concentration of shear at the bone-cement interface leads to micromotion which precipitates a soft-tissue membrane and resorption of the cancellous bone.
A more compliant cement would substantially reduce the interfacial stresses and serve as a “pillow” between the prosthetic stem and the cancellous bone. We have developed a surgically-workable formulation of a reduced modulus acrylic bone cement — polybutylmethylmethacrylate (PBMMA) — to test this hypothesis. Materials property testing and in vivo implantation are discussed.