Boelch Sebastian P, Jordan Martin C, Arnholdt Joerg, Rudert Maximilian, Luedemann Martin, Steinert Andre F
Julius-Maximilians University Wuerzburg, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, 11 Brettreichstrasse, D-97074, Wuerzburg, Germany.
Julius-Maximilians University Wuerzburg, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, 6 Oberduerrbacher Strasse, D-97080, Wuerzburg, Germany.
J Mater Sci Mater Med. 2017 Jul;28(7):104. doi: 10.1007/s10856-017-5915-6. Epub 2017 May 22.
Antibiotic loaded bone cements are used as drug delivery systems for the treatment of periprosthetic joint infections. They can be loaded with antibiotics during industrial component production (premixing) and during cement preparation (manually blending). Although double premixed antibiotic loaded bone cements are available, manually blending of a gentamicin premixed antibiotic loaded bone cement with vancomycin is still popular. We compared in vitro antibiotic elution and compressive strength of 0.5 g gentamicin premixed bone cement (PALACOS® R + G), 0.5 g gentamicin premixed bone cement (PALACOS® R + G) manually blended with 2.0 g vancomycin, 0.5 g gentamicin and 2.0 g vancomycin premixed bone cement (COPAL® G + V), 1 g gentamicin and clindamycin premixed bone cement (COPAL® G + C) and bone cement without an antibiotic (PALACOS® R) as control. Antibiotic concentration measurements were performed for 6 weeks and then compression strength was tested. Concentrations of gentamicin showed no significant differences between PALACOS® R + G, PALACOS® R + G with vancomycin and COPAL G® + V. After 48 h COPAL G® + C produced significantly higher gentamicin concentrations than the other formulations. After 12 h PALACOS® R + G with vancomycin produced significantly higher vancomycin concentrations, but had the lowest compression strength. We found no influence of vancomycin addition on gentamicin elution, irrespectively of the loading method. However, the manually vancomycin blended ALBC produced higher vancomycin concentrations. Compression strength after aging is reduced by loading with vancomycin.
载抗生素骨水泥用作治疗假体周围关节感染的药物递送系统。它们可在工业部件生产期间（预混合）和水泥制备期间（手动混合）加载抗生素。尽管有双预混载抗生素骨水泥，但将庆大霉素预混载抗生素骨水泥与万古霉素手动混合仍很常见。我们比较了0.5g庆大霉素预混骨水泥（PALACOS®R + G）、0.5g庆大霉素预混骨水泥（PALACOS®R + G）与2.0g万古霉素手动混合、0.5g庆大霉素和2.0g万古霉素预混骨水泥（COPAL®G + V）、1g庆大霉素和克林霉素预混骨水泥（COPAL®G + C）以及无抗生素骨水泥（PALACOS®R）作为对照的体外抗生素洗脱和抗压强度。进行了6周的抗生素浓度测量，然后测试抗压强度。庆大霉素浓度在PALACOS®R + G、含万古霉素的PALACOS®R + G和COPAL G® + V之间无显著差异。48小时后，COPAL G® + C产生的庆大霉素浓度明显高于其他配方。12小时后，含万古霉素的PALACOS®R + G产生的万古霉素浓度明显更高，但抗压强度最低。我们发现添加万古霉素对庆大霉素洗脱没有影响，无论加载方法如何。然而，手动混合万古霉素的载抗生素骨水泥产生的万古霉素浓度更高。加载万古霉素会降低老化后的抗压强度。
