Impacts of mixing techniques and vacuum levels on the structural and mechanical properties of PMMA bone cement: A comparative study

= 0.864), while specimen mass showed no predictive value for mechanical performance. Although vacuum mixing reduced porosity, no consistent changes in Young's modulus were detected across the mixing groups. These findings emphasise the importance of porosity control in bone cement preparation and highlight the limitations of current ISO standards. The study advocates for improved testing protocols that more accurately reflect clinical conditions to enhance the predictive value of in vitro assessments of PMMA cement performance.