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Bone cement, also known as polymethylmethacrylate (PMMA), is a synthetic material widely utilized in orthopedic and spinal surgeries to anchor implants, repair fractures, and support weakened bone structures. This biocompatible polymer is typical in procedures such as joint arthroplasty, vertebral augmentation, and fracture fixation, thanks to its unique properties. When mixed with a catalyst, PMMA undergoes a rapid exothermic polymerization process, transforming from a viscous liquid to a solid mass. This characteristic enables it to be applied in a moldable state, allowing for precise placement in the surgical site, where it can bond with bone. The fluid nature of the cement during application allows it to penetrate small defects and voids in the bone, providing a firm and stable fixation once set. Notably, bone cement exhibits excellent mechanical strength and durability, ensuring long-term stability of the implant. However, it is essential to consider its thermal properties, as the polymerization process generates heat, which can affect surrounding tissues if not carefully managed. Additionally, bone cement can enhance the longevity of orthopedic implants by distributing loads evenly, minimizing stress on surrounding bone and potentially reducing the risk of implant loosening. Moreover, its radiopaque nature enables surgeons to visualize the cement intraoperatively and through post-operative imaging, making it easier to assess the effectiveness of the application. One of the significant advancements in bone cement technology is the development of bioactive variants that can release therapeutic agents to enhance bone healing and reduce infection rates. These modifications aim to address some limitations of traditional PMMA, such as bone integration and biological compatibility. Furthermore, the choice of additives can influence the properties of the cement, such as its viscosity and setting time, allowing surgeons to tailor the cement to specific clinical situations. Despite its advantages, the use of bone cement is not without complications. Potential risks include cement leakage, which can lead to vaso-occlusive events or nerve damage, as well as the phenomenon of thermal necrosis due to excessive heat generation during curing. In addition, concerns have been raised regarding the long-term effects of cement on surrounding bone tissue and the potential for allergic reactions in some patients. Therefore, ongoing research is vital to optimize formulations and application techniques, ensuring the safety and efficacy of bone cement in clinical practice. Overall, bone cement represents a critical innovation in the field of orthopedic surgery, enhancing the ability to provide robust and lasting solutions for a variety of skeletal conditions. Its versatility and effectiveness continue to facilitate advancements in surgical techniques, ultimately improving patient outcomes and quality of life. As technology progresses, the future of bone cement is poised for further evolution, with the potential for more biologically integrated and responsive materials that can address the complexities of bone repair and regeneration more effectively.