Methyl methacrylate is used as a cement in neurosurgery and orthopedics. As it transitions from a liquid to a solid, small bubbles can form. A partial bubble in contact with a surface can serve as an avascular space that can harbor bacteria.
Patient selection: persistent bone infection after a neurosurgical or orthopedic operation
Features:
(1) a cement was used in the procedure
(2) air bubbles are seen in the cement grossly or on imaging studies (this is somewhat insensitive)
(4) improvement after replacement of the infected bone or implant
Microscopic examination of the cement shows bubble cavities filled with pus and granulation tissue.
As stated in the paper, "a dead space in a foreign body with free communication to the surrounding tissue often plays an important role in chronic and recurrent infection as a persistent foci."
This absence of this risk may be a plus for a cementless implant.
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