Abstract
Bi-antibiotic-impregnated bone cements (BIBCs) are widely used in orthopaedics as a prophylactic agent (depot) to address post-surgical infections. Although hardness is widely considered a viable index to measure the integrity of the cement structure, there are few specific studies involving changes in hardness characteristics of BIBCs post elution of high doses of two widely used antibiotics: tobramycin and gentamicin. Increased doses of antibiotics and increased duration of elution may also decrease the hardness of polymethyl methacrylate (PMMA) bone cement, thus increasing the chances of shattering, scratching, and deformation.In this project, we have investigated the changes in surface hardness of five different antibiotic-loaded specimens: 0.5 g tobramycin and 0.5 g gentamicin together, 1 g tobramycin, 1 g gentamicin, 5 g tobramycin and 5 g gentamicin together, and 10 g tobramycin (each added to 40 g of PMMA), post elution for various time periods (1, 3, and 21 days). The effect of hydration on the hardness of bone cement was studied to replicate in vivo conditions. The micro-indentation tester (Buehler m5103) was utilized to determine if the increased antibiotic loads would compromise the integrity of the bone cement matrix.The results demonstrated that the amount of drug initially incorporated determined the hardness of the cement post elution. As compared to the control (no antibiotic), specimens containing 1 and 10 g of antibiotic exhibited over 50% and 73% decrease in hardness, respectively. The different treatment durations (post 1 day) as well as the hydration conditions had insignificant effect on the hardness of the cement.Electronic supplementary materialThe online version of this article (doi:10.1186/2194-0517-1-3) contains supplementary material, which is available to authorized users.
Highlights
In recent years, there have been many media highlights on the emerging new medical technology based on the use of absorbable metals
One of them appeared as 2016 BBC Horizons report on “special” metal bone screw implanted in the broken finger bone of a male Korean patient (Horizons 2016)
The interest toward these corrodible or absorbable metals has been rapidly growing. It is marked by the high increase of related scientific publications, the development of new ASTM and ISO standards, and the commercialization of three absorbable metal products
Summary
There have been many media highlights on the emerging new medical technology based on the use of absorbable metals. The patient returned to the hospital 4 months after the surgery with a smile on his face, because his broken bone had been healed and he did not need to go for a second surgery as the screw had disappeared. This innovative metal implant completely dissolves in the body after providing the needed function, eliminating the harmful potential effects of permanent implants. After decades of acknowledging that metal implants must be corrosion resistant, nowadays, corrosion is seen as an advantage The interest toward these corrodible or absorbable metals has been rapidly growing. It is marked by the high increase of related scientific publications, the development of new ASTM and ISO standards, and the commercialization of three absorbable metal products
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