Antimicrobial potential of bioactive bone cements.

Area of Science:

• Biomaterials Science
• Orthopedic Surgery
• Infectious Disease

Background:

• Poly(methyl methacrylate) (PMMA) bone cement is standard for joint arthroplasty.
• Antibiotic incorporation in PMMA aims to prevent/treat bone infections but can compromise mechanical properties.
• Bioactive glasses, like Bioglass(R), bond to tissues and form a hydroxycarbonate apatite layer, showing anti-inflammatory potential.

Purpose of the Study:

• To evaluate the bacteriostatic properties of Bioglass(R)-containing two-paste bone cements.
• To compare these bioactive cements with PMMA cements containing and lacking antibiotics.
• To assess the effect of simulated body fluid (SBF) immersion on the antibacterial efficacy of Bioglass(R) cements.

Main Methods:

• Bacteriostatic properties were assessed using inhibition zone assays against Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis.
• PMMA cements with and without gentamicin were used as controls.
• Bioglass(R) cements were tested both before and after immersion in SBF.

Main Results:

• PMMA cement with gentamicin and Bioglass(R) cements (pre- and post-SBF immersion) showed comparable inhibition zones against all tested bacteria.
• PMMA cement without gentamicin (CMW1) exhibited no inhibition zones.
• Bioglass(R) cements immersed in SBF demonstrated a statistically significant increase in inhibition zones for all bacterial species compared to non-immersed samples (p<0.001).

Conclusions:

• Bioglass(R)-containing bone cements possess bacteriostatic properties comparable to antibiotic-loaded PMMA.
• SBF immersion enhances the antibacterial efficacy of Bioglass(R) cements.
• These bioactive cements represent a viable alternative to traditional PMMA, potentially offering improved bone integration and reduced infection risk.