In-vitro-Untersuchungen zu Elutionskinetiken und antimikrobiellen Wirkungen von Gentamicin- und Clindamycin-haltigen Knochenzementen

Abstract

In arthroplasty and particulary in revision surgery antibiotic-loaded bone cements are applied. The purpose of the current study was to analyse the kinetics of antibiotic release and antimicrobial effects of the gentamicin- and clindamycin-loaded bone cement Versabond. Test cylinders of bone cements, containing gentamicin and clindamycin in different concentrations, were investigated in vitro with regards to the kinetics of antibiotic release by applying static and continuous elution methods. Antimicrobial effects of antibiotic-loaded bone cement were tested in an infection model with different strains of Staphylococcus aureus and Staphylococcus epidermidis and live/dead dye plus fluorescence microscopy. For the surface analysis of antibiotic-loaded test cylinders contaminated with Staphylococcus epidermidis, scanning electron microscopy was used. The measurement of static and continuous elution revealed initially higher rates of gentamicin release in comparison with clindamycin. The gentamicin amount decreased within 24 h, whereas clindamycin-loaded test cylinders showed a prolonged release. After 24 h exclusive avital bacteria on antibiotic-loaded cement cylinders were seen, after 72 h on gentamicin-loaded cement bacterial growth was again detected. Application of antibiotics in bone cement revealed an inhomogeneous surface of the bone cement cylinder. On application of clindamycin in bone cement the features of increased antibiotic uptake and antimicrobial effect compared with gentamicin-loaded bone cement are observed.