Elution, Porosity, and Mechanical Performance of Vancomycin-Loaded Polymethylmethacrylate (PMMA) Bone Cement

Smaller PMMA beads and powder-mixed formulations demonstrated greater early release and higher sustained elution over time, resulting in superior cumulative antibiotic delivery compared with larger beads and liquid-mixed formulations. These findings highlight the need to balance antimicrobial efficacy and mechanical requirements when tailoring formulation of ALBC, particularly in spacer relevant clinical applications.