Mechanical effects of the use of vancomycin and meropenem in acrylic bone cement

Persson, Cecilia; Baleani, Massimiliano; Guandalini, L.; Tigani, Domenico; Viceconti, Marco

doi:10.1080/17453670610012692

Cited by 56 publications

(58 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This loading was the output from the program when the input comprised (1) the three objective functions; (2) the lower and upper bounds on the daptomycin loading (2 wt/wt% and 12 wt/wt%), on the estimated mean fatigue limit (3 MPa and 13 MPa), on the estimated elution rate (3 and 300 lg/mL/g), and on the % inhibition (0% and 100%). The bounds on the daptomycin loading are consistent with the lowest and highest loadings reported in the literature on the influence of antibiotic loading on properties of PMMA bone cements [5,7,13,[19][20][21]25]. The bounds on the estimated mean fatigue limit represent the lowest and highest values of the 95% confidence limits on the fatigue limit of plain PMMA bone cements [22].…”

supporting

confidence: 73%

“…Rather, for each study set, we tested eight specimens at a loading corresponding to a stress (S) of ± 20.0 MPa, 15 specimens at ± 15.0 MPa, six specimens at ± 12.5 MPa, and three specimens at ± 10.0 MPa. The number of specimens tested at each stress level was similar to those used in studies on fatigue tests of ALBC specimens, at comparable stresses, reported in the literature [5,7,20,21,25]. The tests were conducted in ambient laboratory air at a frequency of 2 Hz.…”

mentioning

confidence: 98%

See 1 more Smart Citation

An Approach for Determining Antibiotic Loading for a Physician-directed Antibiotic-loaded PMMA Bone Cement Formulation

Lewis

Brooks

Courtney

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background When a physician-directed antibiotic-loaded polymethylmethacrylate (PMMA) bone cement (ALBC) formulation is used in total hip arthroplasties (THAs) and total knee arthroplasties (TKAs), current practice in the United States involves arbitrary choice of the antibiotic loading (herein defined as the ratio of the mass of the antibiotic added to the mass of the cement powder). We suggest there is a need to develop a rational method for determining this loading. Questions/purposes We propose a new method for determining the antibiotic loading to use when preparing a physician-directed ALBC formulation and illustrate this method using three in vitro properties of an ALBC in which the antibiotic was daptomycin. Materials and MethodsDaptomycin was blended with the powder of the cement using a mechanical mixer. We performed fatigue, elution, and activity tests on three sets of specimens having daptomycin loadings of 2.25, 4.50, and 11.00 wt/wt%. Correlational analyses of the results of these tests were used in conjunction with stated constraints and a nonlinear optimization method to determine the daptomycin loading to use. Results With an increase in daptomycin loading, the estimated mean fatigue limit of the cement decreased, the estimated elution rate of the antibiotic increased, and the percentage inhibition of staphylococcal growth by the eluate remained unchanged at 100%. For a daptomycinloaded PMMA bone cement we computed the optimum amount of daptomycin to mechanically blend with 40 g of cement powder is 1.36 g. Conclusions We suggest an approach that may be used to determine the amount of antibiotic to blend with the powder of a PMMA bone cement when preparing a physician-directed ALBC formulation, and highlighted the attractions and limitations of this approach. Clinical Relevance When a physician-directed ALBC formulation is selected for use in a TKA or THA, the approach we detail may be employed to determine the antibiotic loading to use rather than the empirical approach that is taken in current clinical practice.

show abstract

supporting

confidence: 73%

mentioning

confidence: 98%

An Approach for Determining Antibiotic Loading for a Physician-directed Antibiotic-loaded PMMA Bone Cement Formulation

Lewis

Brooks

Courtney

et al. 2010

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…Although increasing the amount of antibiotic incorporated increases the level of its release [7,13], 4 g or greater of antibiotic to 40 g of PMMA powder compromises the compression strength [7,12], fracture toughness [4], and fatigue life [12,13,17] of the material. Therefore, we investigated whether incorporating bacterial cellulose would improve the mechanical strength of bone cement containing 5 g of antibiotics and increase antibiotic release.…”

Section: Discussionmentioning

confidence: 99%

“…Loading greater than 1 g of antibiotics per 40 g of PMMA powder reduces the fatigue performance of the cement by 40% to 60% [4,12,17]. With antibiotic loading greater than 2 g of antibiotics per 40 g of PMMA powder, the fracture toughness and compression strength are decreased by 15% [4] and 10% to 15% [4,7], respectively.…”

Section: Introductionmentioning

confidence: 99%

Increased Antibiotic Release from a Bone Cement Containing Bacterial Cellulose

Mori

Nakai

Enomoto

et al. 2011

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Major disadvantages of antibiotic bone cements include limited drug release and reduced strength resulting from the addition of high doses of antibiotics. Bacterial cellulose, a three-dimensional hydrophilic mesh, may retain antibiotics and release them gradually. We hypothesized that the addition of cellulose to antibiotic bone cement would improve mechanical strength and antibiotic release. Questions/purposes We therefore examined the mechanical strength and antibiotic release of cellulose antibiotic cement.Methods A high dose of antibiotics (5 g per 40 g cement powder) was incorporated into bacterial cellulose and then mixed with bone cement. We compared the compression strength, fracture toughness, fatigue life, and elution kinetics of this formulation with those of plain cement and a traditional antibiotic cement. Results The average values for compression strength, fracture toughness, and fatigue life of the cellulose antibiotic cement were 97%, 97%, and 78% of the values obtained for plain cement, respectively. The corresponding values for the traditional antibiotic cement were 79%, 82%, and 17%, respectively. The cumulative elution over 35 days was 129% greater from the cellulose antibiotic cement than from the traditional antibiotic cement. Conclusions With a high dose of antibiotics, incorporating cellulose into the bone cement prevented compression and fracture fragility, improved fatigue life, and increased antibiotic elution. Clinical Relevance Antibiotic cements containing cellulose may have applications in clinical situations that require high levels of antibiotic release and preservation of the mechanical properties of the cement.

show abstract

“…Gelatin micro-particles could also be mixed with antibiotic or other therapeutic agents to promote regenerated tissue constructs and to achieve local controlled drug release [18][19][20]. The early clinical study showed reduction of 50 % leakage after the gelatin addition [1].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation

et al. 2013

View full text Add to dashboard Cite

Purpose This study evaluated whether or not the addition of gelatin micro-particles into the polymethyl methacrylate (PMMA) could reduce cement infiltration in cancellous bone of vertebra. Methods Gelatin micro-particles were prepared in various sizes and mixed with PMMA in different densities. Dynamic viscosity of the mixture was measured by a rotational rheometer. Fresh bovine vertebral bodies were sectioned into cylindrical samples. Permeability of the mixture through the samples was tested on a mechanical test machine, and calculated using Darcy's law. The PMMA/gelatin mixture also underwent compressive and bending tests, and their structures were examined by scanning electron microscopy. Results The cement/gelatin mixture increased the viscosity. Significant reduction of cement permeability in cancellous bone was determined after the addition of the micro-particles. Micro-particles of 2 % in density and 125-250 lm in size decreased the permeability by 1/3 without any significant change of the cement viscosity. The biomechanical strength was unchanged in compression but decreased by up to 20 % in bending. Conclusions Gelatin micro-particles significantly increased the cement viscosity, reduced the permeability in cancellous bone of vertebra, decreased the flexural strength, but did not affect the compressive strength. Although it suggested a manageable approach in vertebral augmentation, the outcome should be further verified on a cadaveric model or an animal model before the mixture could be used safely and effectively in the clinical treatment.

show abstract

Mechanical effects of the use of vancomycin and meropenem in acrylic bone cement

Cited by 56 publications

References 24 publications

An Approach for Determining Antibiotic Loading for a Physician-directed Antibiotic-loaded PMMA Bone Cement Formulation

An Approach for Determining Antibiotic Loading for a Physician-directed Antibiotic-loaded PMMA Bone Cement Formulation

Increased Antibiotic Release from a Bone Cement Containing Bacterial Cellulose

Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation

Contact Info

Product

Resources

About