title: Mechanical characteristics of antibiotic-laden bone cement.
abstract: We studied the mechanical characteristics of cement-antibiotic combinations in vitro. Palacos R was tested without antibiotics, with gentamicin alone and with gentamicin plus vancomycin or flucloxacillin. Palacos LV was studied only with gentamicin added. CMW 1 was studied with gentamicin added, with gentamicin plus vancomycin, and with gentamicin plus flucloxacillin. We performed four-point bending tests on beams of cement to establish bending strength and modulus, and compared the values to ISO standards. Density was also assessed. Palacos R was the strongest of the cements (bending strength 80 MPa). Palacos formulations (apart from Palacos LV) had a higher density and bending modulus than CMW 1. Statistical comparison of various cements with plain Palacos R showed lower density in 4 of the mixtures, and lower bending strength and modulus in 6 of the mixtures. Palacos R/gentamicin plus vancomycin and CMW 1/gentamicin plus vancomycin had bending strength slightly above minimum ISO standards, suggesting that the addition of vancomycin during cement mixing may compromise the outcome in revision surgery for sepsis.
authors.affiliation: Avon Orthopaedic Centre, Southmead Hospital, Bristol, UK.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Armstrong
authors.forename: Robert F
authors.initials: RF
authors.lastname: Spencer
authors.forename: James L
authors.initials: JL
authors.lastname: Cunningham
authors.forename: Sabina
authors.initials: S
authors.lastname: Gheduzzi
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Miles
authors.forename: Ian D
authors.initials: ID
authors.lastname: Learmonth
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001843:Bone Cements / Q000493:pharmacokinetics* / Q000627:therapeutic use; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005436:Floxacillin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005839:Gentamicins / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006801:Humans; D066298:In Vitro Techniques; D008422:Materials Testing; D010406:Penicillins / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019904:Polymethyl Methacrylate / Q000493:pharmacokinetics* / Q000627:therapeutic use; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D013314:Stress, Mechanical; D013718:Tensile Strength; D014640:Vancomycin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D005839:Gentamicins; D010406:Penicillins; D005436:Floxacillin; D014640:Vancomycin; D019904:Polymethyl Methacrylate