Abstract
Antibiotic-loaded bone cement (ALBC) is widely used in orthopaedic surgery for both prevention and treatment of infection. Little is known about the effect of different brand combinations of antibiotic and bone cement on the elution profile and mechanical strength of ALBC. Standardized specimens that consisted of one of the 4 brands of bone cement and one of the 3 brands of vancomycin were fashioned, producing 12 combinations of ALBC. Two dosages of vancomycin in 40g bone cement were used to represent the high (4g vancomycin) and low (1g vancomycin) dose groups. Concentrations of vancomycin elution from ALBC was measured for up to 336 hours. The ultimate compression strength was tested at axial compression using a material testing machine before and after elution. In both high-dose and low-dose groups, Lyo-Vancin in PALACOS bone cement resulted in the highest cumulative elution and Vanco in Simplex P bone cement resulted in the lowest elution (458% and 65% higher in high- and low-dose groups, respectively). The mechanical strength was not significantly compromised in all groups with low dose vancomycin (range: 70.31 ± 2.74 MPa to 87.28 ± 8.26MPa after elution). However, with the addition of high dose vancomycin, there was a mixed amount of reduction in the ultimate compression strength after cement aging, ranging from 5% (Vanco in Simplex P, 81.10 ± 0.48 MPa after elution) to 38% (Sterile vancomycin in CMW, 60.94 ± 5.74 MPa after elution). We concluded that the selection of brands of vancomycin and bone cement has a great impact on the release efficacy and mechanical strength of ALBC.
Highlights
Deep infection in orthopaedic surgery is a devastating complication, such as chronic osteomyelitis or periprosthetic joint infection
Elution profiles of cumulative antibiotic released from the different brands of bone cement and different brands of vancomycin with high (4g) and low (1g) dose preparations are shown in Fig 1 and Fig 2, respectively
Osteobond bone cement loaded with Lyo-Vancin had a significantly higher efficiency of antibiotic release than Sterile Vancomycin group and Vanco group (p < 0.05)
Summary
Deep infection in orthopaedic surgery is a devastating complication, such as chronic osteomyelitis or periprosthetic joint infection. Influence of Brand Combination of Vancomycin-Loaded Bone Cement on Elution and Mechanical Strength a prosthesis or implant. Local administration of antibiotics is favored in the treatment of orthopaedic infections. Ever since the introduction and increasing popularity of antibiotic-loaded bone cement (ALBC) use in total joint replacement surgery, deep infections have reduced gradually [2]. ALBC has the ability to deliver high concentration of antibiotics over a period of time and is considered an essential part both in the prevention and treatment of periprosthetic joint infection [3]. The mechanical property of ALBC is pivotal to a successful orthopaedic surgery
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