Prosthetic knee replacement products come in either cemented or cement-less. Cemented products allow the implant to attach to the natural bone of the patient. There are three types of cement: low, medium, and high-viscosity cement (HVC).

Surgeons prefer using HVC because it’s easier to work with and takes less time to mix and set. However, researchers claim it doesn’t bond to the bone and has a higher likelihood of failure.  In 2016, a report published by the National Center for Biotechnology Information (BNBI) observed 13 cases of knee implant failure. This included knee implants failing to stay attached to the cement, or de-bonding from the bone. Researchers found the common issue was HVC.  Implants that used low or medium viscosity did not show signs of de-bonding.

Bone cement complications occur because of bone cement implantation syndrome and aseptic loosening.