Dr. Hubert Büchner

Head of Research and Development, Hereaus Medical

Q: PALACOS® was the first bone cement on the European market. Does PALACOS® still meet the highest standards nowadays?

A: In Scandinavia the quality of prosthetic materials, surgical techniques and methods of fixation in endoprosthetics has been documented and evaluated for decades. The result is absolutely clear: the revision risk was found to be lowest in cemented interventions where PALACOS® was used.
Compared to other bone cements the risk of loosening and infection was up to 50 per cent lower with PALACOS®.

Q: What are the differences between the various makes of bone cement?

A: Even though all the standard bone cements are PMMA-based, there are nevertheless some major differences. The method of manufacturing bone cements is complex and calls for maximum precision. Even minimal discrepancies in cement quality, cement mixture and application can alter the properties of the cement significantly and exert a considerable influence on the service life of the prosthesis.
The manufacture of PALACOS® and all the other bone cements from the Heraeus company is therefore based on very stringent standards. Although bone cement is classified as a medical product, we produce it according to quality criteria which actually apply to pharmaceutical products.

Q: The lifetimes of cemented prostheses are becoming longer and longer. Why is that?

A: Apart from the quality of the prosthesis and bone cement, the cementing technique used also plays a crucial role. Continuous enhancement has been going on ever since the introduction of bone cements. The aim is to provide an optimum interlock between the cement and bone and improve the mechanical properties of the cement matrix.
Bone bed cleaning using Pulse Lavage systems, mixing the cement in a vacuum and retrograde cement application with a cement syringe are now regarded as integral parts of state-of-the-art cementing technique. With the PALAVAGE® and EASYMIX® systems, which are perfectly matched to our products, we provide optimum support for use of state-of-the-art cementing technique.

Q: How will it be possible to achieve even longer lifetimes in future?

A: An optimum surgical outcome depends on good training for all those involved in the operation. Since cementing technique has been enhanced continuously, the operating surgeon and specialised staff in the operating theatre are required to familiarise themselves with the new procedures. With the PALACADEMY®, the training programme sponsored by Heraeus, we have chosen to offer systematic training for surgeons, orthopaedic specialists, hospital pharmacists and specialised operating theatre staff.
In Germany the PALACADEMY® is already in full swing. In Britain as well the training concept of the PALACADEMY® has been very well received. Certification of the PALACADEMY® for British operating theatre staff is already planned with the Association for Perioperative Practice (AfPP).
PALACADEMY® training courses are already available on the Internet. The major benefit is: you can use them anywhere at any time. In interactive course sections you can solve routine surgical problems simply on the screen. In conjunction with events, workshops and presentations the online PALACADEMY® ensures routine in using state-of-the-art cementing technique. Surgeons and orthopaedic specialists will be able to take advantage of special modules at the online PALACADEMY® this year.