Debonding of cemented bone implants is regarded as a major contributor to complications. The relationship between shear bond strength and surface roughness has been investigated, however there are inconsistencies in the trends reported in different studies.

In vitro and in vivo studies have shown that MMA in different ways contribute to activation of coagulation. In addition, MMA per se is cytotoxic and may in clinically relevant concentrations cause disintegration of vascular and blood cells with potential release of proteolytic enzymes and exposure of subendothelial constituents.