The integrity of the cement—bone interface is vital to the long-term stability of cemented hip arthroplasty. Most of the previous studies investigating the interface have been confined to the continuum level, neglecting the effects of microstructure. Microscopic damage at the interface may eventually lead to macroscopic loosening of the implant. However, as the strength of the interface depends on the interlock of the cement with bone and because the properties of cancellous bone depend on its microstructure, the study of the behaviour of the interface at the microstructural level may help to gain an understanding of the factors governing initiation of loosening. In this study, two complementary non-destructive methods, acoustic emission (AE) and computed tomography (CT), have been implemented to study the initiation and progression of damage of an analogue cement—bone interface sample under four-point bending. Early failure was detected, localized, and characterized using AE. CT images of the sample before and after loading were used to visualize damage in three dimensions. Damage initiated at the interface and was found to be related to stress-raising microstructural features in the cement. These were caused by irregularities in the geometry of the bone analogue and recesses and notches formed by the flow of cement.
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