1 PMMA Bone Cement: Properties, Applications, and Innovations 1 Polymethylmethacrylate (PMMA) bone cement has been a fundamental material in orthopedic and dental surgeries for decades, primarily serving to stabilize implants and facilitate bone healing. This review explores the properties, clinical applications, challenges, and recent innovations related to PMMA. The chemical and mechanical properties of PMMA, including its compressive strength and biocompatibility, underscore its utility in procedures such as joint arthroplasties and vertebroplasty. However, limitations such as biomechanical mismatch, thermal damage during polymerization, and susceptibility to infection pose significant challenges. Recent advancements aim to address these issues through the development of antibiotic-loaded formulations, bioactive additives, and smart biomaterials that enhance osseointegration and reduce complications. As research continues to evolve, the future of PMMA bone cement looks promising, with innovations poised to improve patient outcomes and expand its applications in medicine. 1 4 Ali Shirbacheh Service d'urgence,Centre Hospitalier de l'agglomération de Nevers France Shirbacheh.a@ght58.fr Kamran Shirbache Hôpital Robert Debré, Groupe Hospitalier Universitaire AP-HP Nord-Université Paris-Cité France info@jourcc.com Polymethylmethacrylate (PMMA) Bone Cement Orthopedic Biomaterials Article6.pdf [1] F. Ghasemi, A. Jahani, A. Moradi, M.H. Ebrahimzadeh, N. Jirofti, Different Modification Methods of Poly Methyl Methacrylate (PMMA) Bone Cement for Orthopedic Surgery Applications, Arch Bone Jt Surg 11(8) (2023) 485-492 DOI: 10.22038/abjs.2023.71289.3330.##[2] A. Bistolfi, R. Ferracini, C. Albanese, E. Vernè, M. Miola, PMMA-Based Bone Cements and the Problem of Joint Arthroplasty Infections: Status and New Perspectives, Materials (Basel) 12(23) (2019) DOI: 10.3390/ma12234002.##[3] M. Arora, E.K. Chan, S. Gupta, A.D. Diwan, Polymethylmethacrylate bone cements and additives: A review of the literature, World J Orthop 4(2) (2013) 67-74 DOI: 10.5312/wjo.v4.i2.67.##[4] A. Kumar, R. Ghosh, Fracture Toughness of Acrylic PMMA Bone Cement: A Mini-Review, Indian J Orthop 55(5) (2021) 1208-1214 DOI: 10.1007/s43465-021-00495-2.##[5] F.F. Buechel, M.J. Pappas, Principles of human joint replacement: design and clinical application, Springer2015.##[6] P. Choryłek, Vertebroplasty and kyphoplasty-advantages and disadvantages used bone cement of PMMA, Journal of Achievements in Materials and Manufacturing Engineering 92(1-2) (2019) 36-49.##[7] S.M. Pituru, M. Greabu, A. Totan, M. Imre, M. Pantea, T. Spinu, A.M.C. Tancu, N.O. Popoviciu, I.-I. Stanescu, E. Ionescu, A review on the biocompatibility of PMMA-based dental materials for interim prosthetic restorations with a glimpse into their modern manufacturing techniques, Materials 13(13) (2020) 2894.##[8] U. Ali, K.J.B.A. Karim, N.A. Buang, A review of the properties and applications of poly (methyl methacrylate)(PMMA), Polymer Reviews 55(4) (2015) 678-705.##[9] S. Aghyarian, Development and characterization of bioactive bone cements for the treatment of vertebral compression fractures, The University of Texas at Dallas2016.##[10] G. Lewis, Properties of nanofiller‐loaded poly (methyl methacrylate) bone cement composites for orthopedic applications: a review, Journal of Biomedical Materials Research Part B: Applied Biomaterials 105(5) (2017) 1260-1284.##[11] Z. Tang, K. Fujimoto, S. Okazaki, A comparison of the brittle PMMA with the ductile PC on the elasticity and yielding from a molecular dynamics perspective, Polymer 226 (2021) 123809.##[12] F. Ozdemir, Magnetic polymethylmethacrylate cements for hyperthermic cancer treatment, Newcastle University, 2020.##[13] K.-D. Kühn, Bone cements: up-to-date comparison of physical and chemical properties of commercial materials, Springer Science Business Media2012.##[14] M. Falagas, P. Thomaidis, I. Kotsantis, K. Sgouros, G. Samonis, D. Karageorgopoulos, Airborne hydrogen peroxide for disinfection of the hospital environment and infection control: a systematic review, Journal of Hospital Infection 78(3) (2011) 171-177.##[15] M.S. Zafar, Prosthodontic applications of polymethyl methacrylate (PMMA): An update, Polymers 12(10) (2020) 2299.##[16] M. Nodehi, T. Ozbakkaloglu, A. Gholampour, A systematic review of bacteria-based self-healing concrete: Biomineralization, mechanical, and durability properties, Journal of Building Engineering 49 (2022) 104038.##[17] K. Shirbache, H. Nematian, M.H. Nabian, Regenerative medicine owes to microsurgery, Laboratory Animal Research 39(1) (2023) 6 DOI: 10.1186/s42826-023-00158-3.##[18] G. Zhu, G. Wang, J.J. Li, Advances in implant surface modifications to improve osseointegration, Materials Advances 2(21) (2021) 6901-6927.##[19] D.K. Mills, The role of polymer additives in enhancing the response of calcium phosphate cement, Orthopedic Biomaterials: Progress in Biology, Manufacturing, and Industry Perspectives (2018) 345-379.##[20] A. Thesleff, R. Brånemark, B. Håkansson, M. Ortiz-Catalan, Biomechanical characterisation of bone-anchored implant systems for amputation limb prostheses: a systematic review, Annals of biomedical engineering 46 (2018) 377-391.##[21] Q. Wang, J.F. Dong, X. Fang, Y. Chen, Application and modification of bone cement in vertebroplasty: A literature review, Jt Dis Relat Surg 33(2) (2022) 467-478 DOI: 10.52312/jdrs.2022.628.##[22] S.P. von Hertzberg-Boelch, M. Luedemann, M. Rudert, A.F. Steinert, PMMA Bone Cement: Antibiotic Elution and Mechanical Properties in the Context of Clinical Use, Biomedicines 10(8) (2022) 1830.##[23] H. Nematian, K. Shirbache, Z. Vahdati, N. Milan, L.O. Zanjani, M. Firouzi, K. Shirbacheh, M.H. Nabian, Regenerative Medicine in Orthopaedics: Microsurgery Achievements for Translational Animal Model, Open Journal of Regenerative Medicine 12(2) (2023) 21-35.##[24] S. Soleymani Eil Bakhtiari, H.R. Bakhsheshi‐Rad, S. Karbasi, M. Tavakoli, S.A. Hassanzadeh Tabrizi, A.F. Ismail, A. Seifalian, S. RamaKrishna, F. Berto, Poly (methyl methacrylate) bone cement, its rise, growth, downfall and future, Polymer International 70(9) (2021) 1182-1201.##[25] L. Hasandoost, O. Rodriguez, A. Alhalawani, P. Zalzal, E.H. Schemitsch, S.D. Waldman, M. Papini, M.R. Towler, The role of poly (methyl methacrylate) in management of bone loss and infection in revision total knee arthroplasty: A review, Journal of Functional Biomaterials 11(2) (2020) 25.##[26] F. Olsen, Orthogeriatric anaesthesia-studies on the bone cement implantation syndrome, risk prediction and intraoperative haemodynamics, 2021.##[27] I.O. Oladele, L.N. Onuh, N.I. Agbeboh, D.D. Alewi, S.S. Lephuthing, The relationship and functional links between human age, growth, and biomedical implants: A review on the application of bulk and nanomaterials, Nano select 4(7) (2023) 419-441.##[28] A. Bistolfi, R. Ferracini, C. Albanese, E. Vernè, M. Miola, PMMA-based bone cements and the problem of joint arthroplasty infections: status and new perspectives, Materials 12(23) (2019) 4002.##[29] Y. Gong, B. Zhang, L. Yan, A preliminary review of modified polymethyl methacrylate and calcium-based bone cement for improving properties in osteoporotic vertebral compression fractures, Frontiers in Materials 9 (2022) 912713.##[30] M. Furko, K. Balázsi, C. Balázsi, Calcium phosphate loaded biopolymer composites—a comprehensive review on the most recent progress and promising trends, Coatings 13(2) (2023) 360.##[31] H. Wei, J. Cui, K. Lin, J. Xie, X. Wang, Recent advances in smart stimuli-responsive biomaterials for bone therapeutics and regeneration, Bone research 10(1) (2022) 17.