PALACOS® fast R+G - The Fastest1 Element of Success in Joint Replacement

Our fastest setting cement, PALACOS® fast R+G is formulated without a waiting phase for quick handling to reduce OR time costs, while providing the world-famous consistency of PALACOS® cements alongside best-in-class elution rates.

PALACOS® fast R+G is our fastest setting cement with average overall time of less than 6 minutes2 – 30% faster than regular PALACOS® R+G1. This is due, in part, to the lack of a waiting phase (Figure 1). PALACOS® fast R+G also has a significantly higher compressive strength than other fast setting bone cements (Figure 2) increasing the lifespan of the cement in the body.

PALACOS® fast R+G is indicated for use as a bone cement in arthroplasty procedures of the hip, knee and other joints to fix prosthetic parts to living bone when reconstruction is necessary. The cement is indicated for use in the second stage of a two stage revision for total joint arthroplasty after the initial infection has been cleared and is not suitable for anchoring the femoral component of hip joint endoprostheses. Due to its quick setting times, manual mixing of PALACOS® fast R+G is highly recommended.

Figure 1: Fast setting bone cement working times comparison
Figure 1: Fast setting bone cement working times comparison
Figure 2: PALACOS® fast R+G compressive strength comparission to CMW® 2G
Figure 2: PALACOS® fast R+G compressive strength comparission to CMW® 2G

PALACOS® fast R+G has up to 37.8% faster working times than traditional bone cements1 and includes the benefits of no waiting time and a very short setting time. Reduction in time spent waiting on cement preparation and/or setting can reduce direct OR costs by as much as 50 dollars per surgery and have an opportunity cost savings of 155 dollars per surgery3.

In addition to direct OR savings, PALACOS® R+G has been proven to have the lowest risk ratio for revision by the National Joint Registry UK and a 6.1% lower failure rate than all other studied cements4,††. PALACOS® fast R+G provides the same proven success in infection management while providing up to 5x higher elution rates than other fast setting cements despite containing 40% less gentamicin (Figure 3).

For more information on PALACOS® fast R+G and its working and handling properties, please reach out to your local Heraeus representative.

PALACOS® R+G is indicated for use in the second stage of a two stage revision after the initial infection has been cleared.

†† We thank the patients and staff of all the hospitals in England, Wales, Northern Ireland and the Isle of Man who have contributed data to the National Joint Registry. We are grateful to the Healthcare Quality Improvement Partnership (HQIP), the NJR Steering Committee and staff at the NJR Centre for facilitating this work. The views expressed represent those of Heraeus Medical GmbH and do not necessarily reflect those of the National Joint Registry Steering Committee or the Health Quality Improvement Partnership (HQIP) who do not vouch for how the information is presented.

Figure 3: PALACOS® fast R+G elution rate
Figure 3: PALACOS® fast R+G elution rate

Literature:
1 Caraan NA, Winghager R, Webb J, Zentgraf N, Kuehn KD. Role of fast-setting cements in arthroplasty: a comparative analysis of characteristics. World J Orthop 2017; 8(12): 881-890.
2 IFU CMW Smartset, 2014 and IFU PALACOS® fast R+G, 2013.
3 Childers CP, Maggard-Gibbons M. Understanding Costs of Care in the Operating Room. JAMA Surg 2018; 153(4): e176233.
4 Compared to CMW 1; Furnes et. al. (2005). Properties of bone cement: Which cement should we choose for Primary THA? The Well-Cemented Total Hip Arthroplasty: Theory and Practice, Part II, pp. 103–106; Springer Berlin Heidelberg, ISBN: 978-3-540-24197-3

Figures:
Figure 1: IFU CMW Smartset, 2014 and IFU PALACOS® fast R+G, 2013.
Figure 2: Caraan NA, Winghager R, Webb J, Zentgraf N, Kuehn KD. Role of fast-setting cements in arthroplasty: a comparative analysis of characteristics. World J Orthop 2017; 8(12): 881-890.
Figure 3: Caraan N. et. Al. (2015), Comparative Analysis of the Characteristics of Fast-Setting PMMA-Cements (E-Poster Presentation) ISTA Kongress Vienna, Session 4 Knee Implant Fixation & Revision, 4-7-7

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