The effects of adding 1.0 cc of aqueous methylene blue dye as a visual contrast agent to a standard 40 g pack of acrylic bone cement are determined. These cements are evaluated: Simplex P (Radiopaque), Zimmer Bone Cement, and Zimmer LVC Bone Cement. Seven tests were performed. Leach out is less than 2.0% and was undetectable after day 8. Biocompatibility using a rabbit model shows contrast and white cement to be equivalent. Tension, compression, and 3- and 4-point bending strengths are not significantly altered except for a slight increase in 4-point bending strength for contrast Zimmer (regular) bone cement. Dough, set, and working times are decreased by 30-150 s. The ASTM F451 intrusion standards are met for all three contrast cements. Viscosity increases more rapidly for contrast cement, but remains sufficiently low (less than 100 N-s/m2) early after mixing to allow good penetration into bone. Ease of removal and visualization of contrast cement are shown by revision of cemented femoral total hip components in synthetic and cadaver femurs and by debriding cement particles from a soft tissue background coated with blood. The use of contrast bone cement appears to be both safe and efficacious for use in initial and revision total joint replacements. Because of the decreased working times, its use is recommended only by experienced surgeons.