Abstract: An apparatus for mixing bone cement can comprise a receiving chamber, a mixing chamber, a cannula, a base, and a piston located within the mixing chamber. The receiving chamber defining a conduit. The mixing chamber in fluid communication with the receiving chamber. The mixing chamber configured to house a first component of the bone cement. The cannula located in the receiving chamber and in fluid communication with the conduit. The base including a bladder arranged to be punctured by the cannula, the bladder configured to house a second component of the bone cement. Upon puncturing of the bladder by the cannula the second component of the bone cement passes through the conduit and the cannula into the mixing chamber. The piston configured to seal the mixing chamber upon movement of the piston from a first position relative to the conduit to a second position relative to the conduit.