50 years PALACOS R+G - a joint success story

ADVANCING, TOGETHER

For 50 years PALACOS® R+G* has been synonymous with unique product quality to provide patients with better outcomes. PALACOS® R+G* relies on a wide range of people working together to achieve success, including:

  • forerunners in material development
  • first users and pioneers in arthroplasty
  • those who produce and optimize PALACOS® R+G* day in, day out
  • healthcare professionals who use PALACOS® R+G* for the benefit of their patients.

PALACOS® R+G* is our success story that we can all be proud of.

Thank you for decades of trusted collaboration for best patient outcomes.

Who are the people behind PALACOS® R+G?

For the 50th anniversary, they share their stories about their experiences with the product.

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Dr. Matthew Dietz, Orthopedic Surgeon and Associate Professor

“What makes Palacos R+G so special is the consistency and reliability. In the operating room, it seems like every day there’s something different. To have something be there that you can trust and rely on in each case, I think is really important for the excellent outcomes for the patient.”

Dr. Dietz works as an Orthopedic Surgeon and Associate Professor at West Virginia University specializing in hip and knee replacements and complicated revisions with research interest in implant associated infections.

A journey through time with PALACOS® R+G*

Otto Röhm (1878-1939)

1901 – It all starts with ‘organic glass’

The chemist Otto Röhm lays the foundation for the manufacture of the new plastic polymethyl methacrylate, or PMMA, with his dissertation entitled ‘Polymerisation products from acrylic acid’ (original: „Über Polymerisationsprodukte der Acrylsäure“). Röhm calls it ‘organic glass’ – today, it is better known as plexiglass.

Otto Haas (1872-1960)

1928 – Industrial-scale manufacture by Röhm & Haas

Otto Röhm and Otto Haas make refinements to the acrylate at their research lab and develop a method for synthesising methyl methacrylate (MMA) on an industrial scale.

Artificial dentures with MMA

1935 – First artificial dental prosthesis with MMA

Walter Bauer, head of the Röhm & Haas research lab, patents the process for manufacturing dental prostheses using methyl methacrylate (MMA). At the same time, the lab continues to work on further application areas.

Moulding compound made from PMMA and liquid monomer

1936 – Heraeus (Kulzer) patents heat curing moulding compound

Heraeus (Kulzer) discovers that mixing ground PMMA cement powder and monomer liquid creates a pasty compound, which sets when heated to 100°C with benzoyl peroxide (BPO). This process is known as ‘heat curing’.

PMMA plates for cranioplasty

1941 – PMMA used in plastic surgery for the first time

Kleinschmitt uses pre-formed and pre-cured PMMA plates of the heat-curing polymer PALADON® 65 for the first time to repair cranial defects.

Mixing phases with bone cement

1943 – PMMA bone cement makes its debut

Heraeus (Kulzer) and Degussa patent a process for ‘cold curing’ a PMMA cement mixture at room temperature. This discovery lays the foundation for the chemical processes still used today.

Hip Arthroplasty with acrylic Prosthesis (1951)

1951 – Cold-curing PMMA used for the first time

The surgeon Sven Kiaer uses cold-curing PMMA as a pure anchoring material for the first time. The process involves anchoring acrylic glass caps on the femoral head after cartilage is removed.

Sir John Charnley (1911-1982)

1958 – Pioneering work in arthroplasty

British orthopedic surgeon Sir John Charnley anchors a total hip endoprosthesis for the first time using cold-curing PMMA. Charnley refers to this as ‘acrylic-based bone cement’. Early studies show excellent tissue tolerance and implant survival of up to 30 years.

PALACOS R (1959)

1959 – PALACOS® is the first bone cement used in Germany

Heraeus (Kulzer) introduces Germany’s first bone cement. The company manufactures it in-house according to its own formula. The PALACOS® success story begins, with a market share of over 80% by the end of the 1960s. The formula with the green colorant, which is based on chlorophyll, is still in use today.

Letter of Hans-Wilhelm Buchholz to Heraeus (Kulzer)

1969 – A revolution reduces the number of revisions

Prof. Hans-Wilhelm Buchholz writes to Heraeus (Kulzer), saying the following: “If it were possible to impregnate Palacos with individual antibiotics … it would be extremely significant from a clinical perspective”. There is also the question of whether it might be possible to release an active substance from the cement matrix. Sir John Charnley is skeptical: “My dear Buchholz, nothing leaks out of a stone.” However, adding gentamicin sulphate to PALACOS® R yields promising results, with fewer infections arising following a joint replacement.

PALACOS R+G (1972)

1972 – Europe-wide distribution through Merck and Schering Plough

Still to this day, Heraeus (Kulzer) manufactures and holds the rights to PALACOS® with and without gentamicin. With the German Drug Law coming into force and without the necessary authorization to produce pharmaceuticals (the company is registered as a dental firm) at this time, Heraeus (Kulzer) entrusts the authorization and distribution of PALACOS® and Refobacin® PALACOS® R (today PALACOS® R+G*) to two companies: Merck and Schering Plough.

Reduction of periprosthetic infection rates hrough PALACOS R+G

1981 – Reduction in periprosthetic infections

Long-term studies show that the antibacterial efficacy of PALACOS® R+G* helps to reduce periprosthetic infections in the long term.3

PALACOS R+G 2004

2004 – One-stop shop: Heraeus Medical takes over distribution

Heraeus Medical is founded as a subsidiary of Heraeus (Kulzer). As well as continuing with the development and manufacture of its proven PALACOS® bone cements, the company also begins selling its own products.

PALAMIX

2008 – PALAMIX® optimizes the use of PALACOS®

Mixing under vacuum reduces porosity and strengthens the bond between bone cement and prosthesis. PALAMIX® enables bone cements like PALACOS® R+G* to be mixed in a reproducibly high quality.

PALACOS Pro

2012 – Ready-to-Mix with PALACOS® R+G* pro

PALACOS® R+G* pro is launched. The closed All-in-One Fixation SystemTM is a combination of the gold standard PALACOS® R+G* and a vacuum mixing and application system. This enables bone cement components to be handled safely and without contact.

Facts about PALACOS

2018 – Not all cements are the same

Cement quality has been shown to be a key factor for long-term implant survival.1 PALACOS® is the most studied bone cement and leads in clinical evidence.2

Use of PALACOS in the world

2019 – PALACOS® at home in the world

PALACOS® has been used in arthroplasty for 60 years and is available in over 90 countries around the world.

34 Million Procedures with PALACOS

2021 – The gold standard in arthroplasty

PALACOS® has been used in over 34 million procedures to date.

50 years PALACOS R+G

2022 – Advancing, Together

We are celebrating globally 50 years of PALACOS® R+G*. We would like to say thank you to all who have contributed to this success, those who have helped to develop, produce, optimize and use PALACOS® R+G*.

* In the United States, PALACOS® R+G is indicated for use in the second stage of a two stage revision for the total joint arthroplasty after the initial infection has been cleared.

1 Furnes O., Havelin L., Espehaug B. Properties of bone cement - which cement should we choose for primary THA? In: Breusch S, Malchau H, eds. The Well- Cemented Total Hip Arthroplasty. Springer Verlag 2005; 103–106.

2 Pilz V., Hanstein T. Literature Review of the Clinical Evidence Situation of Bone Cements. RRJMHS Vol. 7 Issue 1 March, 2018; 31–36.

3 Buchholz et al. Management of deep infection of total hip replacement. J Bone Joint Surg Br 1981; 63-B(3): 342–353.