Practical considerations in the making and use of high-dose antibiotic-loaded bone cement.

Local antibiotic delivery with antibiotic loaded acrylic bone cement has been used extensively in the management of chronic osteomyelitis and implant related infections. Though newer drug delivery vehicles are being investigated, it remains the most widely used local antibiotic delivery vehicle in orthopaedic surgery. Self-made antibiotic loaded bone cement beads, which are cheaper and antibiotic specific, have been shown to elute less effectively than commercial antibiotic loaded cement beads. We offer several tips for increasing the elution and effectiveness of antibiotic loaded bone cement in clinical practice.