Coloured bone cements have been introduced to
make the removal of cement debris easier at the time of primary and
revision joint replacement. We evaluated the physical, mechanical
and pharmacological effects of adding methylene blue to bone cement
with or without antibiotics (gentamicin, vancomycin or both). The
addition of methylene blue to plain cement significantly decreased
its mean setting time (570 seconds (sd 4) vs 775 seconds
(sd 11), p = 0.01), mean compression strength (95.4 MPa
(sd 3) vs 100.1 MPa (sd 6), p =
0.03), and mean bending strength (65.2 MPa (sd 5) vs 76.6
MPa (sd 4), p <
0.001) as well as its mean elastic modulus
(2744 MPa (sd 97) vs 3281 MPa (sd 110),
p <
0.001). The supplementation of the coloured cement with vancomycin
and gentamicin decreased its mean bending resistance (55.7 MPa (sd 4) vs 65.2
MPa (sd 5), p <
0.001).The methylene blue
significantly decreased the mean release of gentamicin alone (228.2
µg (sd 24) vs 385.5 µg (sd 26),
p <
0.001) or in combination with vancomycin (498.5 µg (sd 70) vs 613
µg (sd 25), p = 0.018) from the bone cement. This study
demonstrates several theoretical disadvantages of the antibiotic-loaded
bone cement coloured with methylene blue.