{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:53Z","timestamp":1787755313934,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"\n Background:<\/jats:title>\n Retained polymethylmethacrylate (PMMA) in surgical instrument trays and on instruments is becoming more common and is a disquieting situation for the arthroplasty operating room team. Although retained debris may be sterile after autoclaving, previous studies have not specifically investigated bacterial viability on retained PMMA. This study determined whether heavily contaminated PMMA surfaces and instruments covered in PMMA could be effectively sterilized by clinically utilized autoclaving protocols.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Mature methicillin-susceptible\n Staphylococcus aureus<\/jats:italic>\n (MSSA) and\n Escherichia coli<\/jats:italic>\n biofilms were grown on PMMA coupons with a smooth surface (n = 5 per condition) or with deep crevices (n = 5 per condition) and on threaded screws, which were inserted into polymerizing PMMA (n = 5 per condition). PMMA coupons and PMMA-covered screws were subjected to 3 autoclave sterilization protocols. Colony-forming unit (CFU) counts and adenosine triphosphate (ATP) levels were measured to detect viable bacteria. Scanning electron microscope (SEM) images were obtained to determine whether biofilm was present.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Non-autoclaved PMMA surfaces were heavily contaminated, with values of 4.1 \u00b1 2.3 \u00d7 10\n 6<\/jats:sup>\n CFUs\/mL for\n S<\/jats:italic>\n .\n aureus<\/jats:italic>\n and 2.4 \u00b1 1.2 \u00d7 10\n 6<\/jats:sup>\n CFUs\/mL for\n E<\/jats:italic>\n .\n coli.<\/jats:italic>\n ATP levels of 3,230 \u00b1 1,297 relative light units (RLU) for\n S<\/jats:italic>\n .\n aureus<\/jats:italic>\n and 1,006 \u00b1 602 RLU for\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n were observed. Crevices and screws were also heavily contaminated. Following autoclaving, CFUs\/mL counts of <10 and RLU levels of <5 (beneath the hygienic threshold for cleanliness) were recorded on all PMMA surfaces, crevices, and screws. SEM confirmed that the biofilm structures remained intact, but they did not contain viable bacteria.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n PMMA and PMMA-covered instruments contaminated with gram-positive or gram-negative biofilms are effectively sterilized using clinical autoclaving protocols.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance:<\/jats:title>\n Retained PMMA and PMMA-covered surgical instruments that undergo a clinical autoclaving protocol do not carry viable bacteria.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.25.00655","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T19:00:15Z","timestamp":1769194815000},"page":"672-678","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Autoclaving Effectively Sterilizes Contaminated Retained Cement in Orthopaedic Surgical Trays"],"prefix":"10.2106","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2884-8353","authenticated-orcid":false,"given":"Andrew L.","family":"Thomson","sequence":"first","affiliation":[{"name":"Arthroplasty Research Laboratory, Research Institute, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-5368","authenticated-orcid":false,"given":"Christina","family":"Chao","sequence":"additional","affiliation":[{"name":"Arthroplasty Research Laboratory, Research Institute, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7242-5348","authenticated-orcid":false,"given":"Mohammad","family":"Hammad","sequence":"additional","affiliation":[{"name":"Arthroplasty Research Laboratory, Research Institute, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Mendia","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0906-7554","authenticated-orcid":false,"given":"Mathias P.G.","family":"Bostrom","sequence":"additional","affiliation":[{"name":"Arthroplasty Research Laboratory, Research Institute, Hospital for Special Surgery, New York, NY"},{"name":"Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3129-705X","authenticated-orcid":false,"given":"Alberto V.","family":"Carli","sequence":"additional","affiliation":[{"name":"Arthroplasty Research Laboratory, Research Institute, Hospital for Special Surgery, New York, NY"},{"name":"Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"issue":"2","key":"bib1-20260506","first-page":"71","article-title":"Retained bioburden on surgical instruments after reprocessing. 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