Abstract
Bone void fillers (BVFs) containing calcium sulfate, tricalcium phosphate (TCP), and hydroxyapatite can be loaded with antibiotics for infection treatment or prevention under surgeon-directed use. The aim of this study was to characterize the handling and elution properties of a triphasic BVF loaded with common antibiotics. BVF was mixed with vancomycin and/or tobramycin to form pellets, and the set time was recorded. A partial refreshment elution study was conducted with time points at 4, 8, and 24 h, as well as 2, 7, 14, 28, and 42 days. Effects on dissolution were evaluated in a 14-day dissolution study. Set time increased to over 1 h for groups containing tobramycin, although vancomycin had a minimal effect. Pellets continued to elute antibiotics throughout the 42-day elution study, suggesting efficacy for the treatment or prevention of orthopedic infections. BVF containing vancomycin or tobramycin showed similar dissolution at 14 days compared to BVF without antibiotics; however, BVF containing both antibiotics showed significantly more dissolution.
Highlights
Bone grafting is a well-established surgical practice in which osseous defects created by trauma, tumor resection, or arthroplasty are filled using donor-harvested bone or by using other synthetic alternatives [1,2,3,4,5,6,7]
Bone void fillers (BVFs) containing tobramycin or a combination of tobramycin and vancomycin did not set within the 1.5 h study period; they were declared set after sitting overnight for a total of 15 h
Vicat testing, according to ASTM C472, showed that BVF set at 3.5 min without antibiotics and 5 min with vancomycin only
Summary
Bone grafting is a well-established surgical practice in which osseous defects created by trauma, tumor resection, or arthroplasty are filled using donor-harvested bone or by using other synthetic alternatives [1,2,3,4,5,6,7]. Autografts, sections of bone harvested from the patient’s iliac crest, are considered the gold standard of bone grafts due to their osteoconductive, osteoinductive, and osteogenic properties. These procedures, require a second surgical site and have limitations including pain, complications of the harvest site, and limited amounts of bone [2,4,5,8,9,10,11]. Three common types of calcium bone void fillers (BVF) used clinically are calcium sulfate, tricalcium phosphate, and hydroxyapatite
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