Kisanuki Osamu, Yajima Hiroshi, Umeda Tomohiro, Takakura Yoshinori
Department of Orthopaedic Surgery, Yoshimoto Orthopaedic Surgery and Surgical Hospital, 136 Noguchi, Yamatotakada, Nara, 635-0075, Japan.
J Orthop Sci. 2007 May;12(3):281-8. doi: 10.1007/s00776-007-1124-3. Epub 2007 May 31.
The present study was undertaken to examine whether antibiotic-impregnated calcium phosphate cement (CPC) would provide a valid means of treating osteomyelitis.
The antibiotic used for the impregnation was dideoxy-kanamycin B (DKB), which is available in two forms (powder and liquid). Columnar test specimens (diameter 7 mm, height 14 mm) were prepared by adding the liquid or powdered DKB. Group A: Three types (6.25-titer, 12.5-titer, 25-titer) of test specimen were prepared by mixing the setting solution and DKB solutions into cement. Group B: Three types (25-titer, 50-titer, 100-titer) of test specimen were prepared by mixing the setting solution and DKB powder into cement. Group C: A control specimen was prepared by mixing the setting solution into the cement. The study included a consistency test, setting-time test, compressive strength test, porosity test, and elution test.
The value for the consistency test was >23 mm in all test groups. The results of the setting-time test showed that the setting time became significantly longer as the DKB content increased for groups A group B. Compressive strength decreased as the antibiotic content increased, although all specimens remained sufficiently strong for clinical application. In group A the porosity did not differ significantly depending on the antibiotic content, whereas in group B the porosity increased significantly as the antibiotic content increased. In the elution test using specimens with the same titer (25 titer), the elution efficiency was higher in group A than in group B, and the duration of elution was longer in group A.
Although polymethylmethacrylate (PMMA) has been conventionally used as a drug-delivery system (DDS), the results of the present study indicate that CPC shows better elution efficiency than PMMA. It is thus a promising DDS for the treatment of osteomyelitis.
本研究旨在探讨抗生素浸渍磷酸钙骨水泥（CPC）是否能提供一种有效的治疗骨髓炎的方法。
用于浸渍的抗生素是双脱氧卡那霉素B（DKB），有两种形式（粉末和液体）。通过添加液体或粉末状DKB制备柱状测试样本（直径7毫米，高14毫米）。A组：通过将凝固液和DKB溶液混合到骨水泥中制备三种类型（6.25效价、12.5效价、25效价）的测试样本。B组：通过将凝固液和DKB粉末混合到骨水泥中制备三种类型（25效价、50效价、100效价）的测试样本。C组：通过将凝固液混合到骨水泥中制备对照样本。该研究包括稠度试验、凝固时间试验、抗压强度试验、孔隙率试验和洗脱试验。
所有测试组的稠度试验值均>23毫米。凝固时间试验结果表明，A组和B组中，随着DKB含量增加，凝固时间显著延长。随着抗生素含量增加，抗压强度降低，不过所有样本的强度仍足以满足临床应用。在A组中，孔隙率随抗生素含量变化无显著差异，而在B组中，孔隙率随抗生素含量增加显著升高。在使用相同效价（25效价）样本的洗脱试验中，A组的洗脱效率高于B组，且A组的洗脱持续时间更长。
虽然传统上聚甲基丙烯酸甲酯（PMMA）一直用作药物递送系统（DDS），但本研究结果表明，CPC的洗脱效率优于PMMA。因此，它是一种有前景的用于治疗骨髓炎的DDS。
