Egger Valentina, Dammerer Dietmar, Degenhart Gerald, Pallua Johannes D, Schmölz Werner, Thaler Martin, Kühn Klaus-Dieter, Nogler Michael, Putzer David
Department of Orthopaedic and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Department for Orthopaedics and Traumatology, University Hospital Krems, 3500 Krems an der Donau, Austria.
Polymers (Basel). 2024 Aug 22;16(16):2378. doi: 10.3390/polym16162378.
The increasing numbers of total joint replacements and related implant-associated infections demand solutions, which can provide a high-dose local delivery of antibiotics. Antibiotic-loaded bone cement (ALBC) is an accepted treatment method for infected joint arthroplasties. The mechanical properties of low-dose gentamicin-loaded bone cement (BC) in medium- and high-viscosity versions were compared to unloaded BC using a vacuum mixing system. As an additional control group, manual mixed unloaded BC was used. In a uniaxial compression test, ultimate compressive strength, compressive yield strength, and compression modulus of elasticity, as well as ultimate and yield strain, were determined according to ISO 5833-2022 guidelines. All groups exceeded the minimum compressive strength (70 MPa) specified in the ISO 5833 guidelines. Both ALBC groups showed a similar ultimate compressive and yield strength to the unloaded BC. The results showed that vacuum mixing increased the compression strength of BC. ALBC showed similar compressive strength to their non-antibiotic counterparts when vacuum mixing was performed. Added low-dose gentamicin acted as a plasticizer on bone cement. From a biomechanical point of view, the usage of gentamicin-based ALBC formulations is viable.
全关节置换术数量的不断增加以及与之相关的植入物相关感染需要能够提供高剂量局部抗生素递送的解决方案。载抗生素骨水泥(ALBC)是治疗感染性关节置换术的一种公认方法。使用真空混合系统,将中粘度和高粘度版本的低剂量庆大霉素载骨水泥(BC)的力学性能与未载药的BC进行比较。作为额外的对照组,使用手动混合的未载药BC。在单轴压缩试验中,根据ISO 5833-2022指南测定极限抗压强度、抗压屈服强度和压缩弹性模量,以及极限应变和屈服应变。所有组均超过了ISO 5833指南规定的最低抗压强度(70MPa)。两个ALBC组的极限抗压强度和屈服强度与未载药的BC相似。结果表明,真空混合提高了BC的抗压强度。进行真空混合时,ALBC与其不含抗生素的对应物表现出相似的抗压强度。添加的低剂量庆大霉素对骨水泥起到了增塑剂的作用。从生物力学角度来看,基于庆大霉素的ALBC配方的使用是可行的。