Efficacy of vacuum bone cement mixing systems in reducing methylmethacrylate fume exposure: comparison of 7 different mixing devices and handmixing.

Background: Polymethylmethacrylate (PMMA) bone cements are mainly used for implant fixation in joint replacement surgery. During cement preparation for application, all staff in the operating theatre are exposed to methylmethacrylate (MMA) fumes, which are known to have toxic side effects.

Methods and results: In this study we found that vacuum mixing of bone cement with 7 commercially available mixing devices significantly reduced the emission of MMA vapors in the breathing zone when compared with classic hand mixing in an open bowl. Gas chromatography appears to be more sensitive for detection of MMA fumes than Photo Inonization Detection.

Interpretation: According to present knowledge, even repeated mixing of PMMA bone cement during a normal working day does not seem to constitute an increased health risk, particularly if vacuum mixing is implemented.