Effect of varying surface patterns on antibiotic elution from antibiotic-loaded bone cement

A simple method for fashioning an antibiotic impregnated cemented rod for intramedullary placement in infected non-union of long bones

“…PMMA rods fashioned with our technique are quite helpful in these situations as far as stability component is considered, apart from splints and POP casts a spanning external fixator or bridging LCP with minimum number of screws can be used. Several studies 15,18,19 have shown that antibiotic cement beads have effective local antibiotic delivery owing to more surface area of spherical construct but removal is usually difficult in comparison to cylindrical construct. This difficulty in removal of antibiotic beads can also be overcome by using bio-degradable antibiotic delivery system 20 but at the cost of compromised stability at the non-union site and increased expenditure.…”

Antibiotic Loaded Acrylic Bone Cement in Orthopaedic Trauma

“…The diffusion theory relies on the presence of pores and connecting capillaries in bone cement, through which the circulating medium penetrates and dissolves the incorporated antibiotics which then slowly diffuse outwards (van de Belt et al, 2001). However, others have argued that a critical review of the data they presented does not support this conclusion (Masri et al, 1995).…”

“…The most commonly accepted theory is that the elution of antibiotics occurs from the surface of the bone cement and also from the pores and cracks in its matrix (van de Belt et al, 2001;Masri et al, 1995). In support of this theory, elution is improved with increasing surface area and porosity of the cement.…”

“…In support of this theory, elution is improved with increasing surface area and porosity of the cement. Numerous studies have shown that that elution of antibiotics is a surface phenomenon that is related to pores and cracks within the bone cement matrix (Marks et al, 1976;Masri et al, 1995;Wroblewski, 1977;Baker and Greenham, 1988). Van de Belt et al studied the release of gentamicin as a function of time from six different gentamicin-loaded bone cements and related it to surface roughness, porosity and wettability of the cements.…”

“…The elution of antibiotics occurs from the surface of the bone cement and also from the pores and cracks in its matrix (Masri et al, 1995). Elution is improved with increasing surface area and porosity of the cement exposed to liquid medium (Masri et al, 1995).…”