Antibiotic Bone Cement: Are Timing and Dosing Important Variables for Vancomycin Elution?

Abstract

Polymethylmethacrylate (PMMA) combined with antibiotics provides a simple and efficient way to treat infection and osteomyelitis locally, provided that an adequate excisional debridement was performed initially and adjunctive systemic antibiotics are utilized1. The PMMA provides a stable structure for total joint arthroplasty with cement and intramedullary implants for long-bone nonunions. PMMA can fill dead space in osteomyelitis or open fractures with bone loss. The PMMA can be injected into a medullary canal for arthroplasty2, can be made into multiple beads for open fractures with bone loss3, and can be utilized in a custom nail for infected long-bone nonunions4. The combination of PMMA with heat-stable antibiotics such as vancomycin or tobramycin allows for elution of the antibiotics over a time period5. Improving antibiotic elution without hampering the biomechanical nature of PMMA is desired. In this study, two variables of PMMA (Simplex P and SmartSet MV) …