Orthopedic-grade PMMA bone cement, admixed with prophylactic antibiotics, is widely used in hip and knee replacement surgery. There is a critical need to improve its structural integrity and to control antibiotic release. In this study, clay nanotubes are loaded with the antibiotic gentamicin sulfate and the cement is doped with 5–8 wt% nanotubes. The halloysite nanotubes isolate the drug from the cement monomers and serve as nanocontainers for sustained release of the antibiotic. Gentamicin-loaded clay nanotubes admixed in PMMA cement provide sustained release up to 300–400 h and with enhanced release at cement cracks. The PMMA/halloysite/gentamicin composite tensile strength does not deteriorate as compared with pure cement and its adhesion to bone is significantly increased.