title: Increased antibiotic release and equivalent biomechanics of a spacer cement without hard radio contrast agents.
abstract: We compared a novel calcium carbonate spacer cement (Copal® spacem) to well-established bone cements. Electron microscopic structure and elution properties of the antibiotics ofloxacin, vancomycin, clindamycin, and gentamicin were examined. A knee wear simulator model for articulating cement spacers was established. Mechanical tests for bending strength, flexural modulus, and compressive and fatigue strength were performed. The electron microscopic analysis showed a microporous structure of the spacer cement, and this promoted a significantly higher and longer antibiotic elution. All spacer cement specimens released the antibiotics for a period of up to 50days with the exception of the vancomycin loading. The spacer cement showed significantly less wear scars and fulfilled the ISO 5833 requirements. The newly developed spacer cement is a hydrophilic antibiotic carrier with an increased release. Cement without hard radio contrast agents can improve tribological behaviour of spacers, and this may reduce reactive wear particles and abrasive bone defects.
authors.affiliation: Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a 69118, Heidelberg, Germany. Electronic address: Rudi.Bitsch@med.uni-heidelberg.de.
authors.forename: R G
authors.initials: RG
authors.lastname: Bitsch
authors.affiliation: Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a 69118, Heidelberg, Germany.
authors.forename: J P
authors.initials: JP
authors.lastname: Kretzer
authors.affiliation: Heraeus Medical GmbH, 61273 Wehrheim, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Vogt
authors.affiliation: Heraeus Medical GmbH, 61273 Wehrheim, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Büchner
authors.affiliation: Klinikum Mittelbaden, 76530 Baden-Baden, Germany.
authors.forename: M N
authors.initials: MN
authors.lastname: Thomsen
authors.affiliation: Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a 69118, Heidelberg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Lehner
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D001696:Biomechanical Phenomena; D001843:Bone Cements; D004337:Drug Carriers; D008422:Materials Testing; D008854:Microscopy, Electron; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements; D004337:Drug Carriers
keywords: Antibiotic loading; Cement spacer; Compression strength; Elution kinetics; Tribological wear analysis