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Oritavancin polymethylmethacrylate (PMMA)-compressive strength testing and in vitro elution
Suzannah M Schmidt-Malan1, Kerryl E Greenwood-Quaintance1, Lawrence J Berglund2
1Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Journal of Orthopaedic Surgery and Research
|February 14, 2019
Summary
Oritavancin-loaded polymethylmethacrylate (PMMA) demonstrates superior mechanical strength and reduced elution compared to vancomycin-loaded PMMA, suggesting its potential for orthopedic infection treatment.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Infectious Diseases
Background:
- Polymethylmethacrylate (PMMA) is utilized for localized antimicrobial delivery in orthopedic infections.
- Oritavancin, a lipoglycopeptide antibiotic, exhibits potent activity against Gram-positive bacteria.
- This study investigates the impact of oritavancin incorporation into PMMA on its mechanical properties and drug elution profile compared to vancomycin.
Purpose of the Study:
- To evaluate the effect of 7.5% w/w oritavancin on the compressive strength and elastic moduli of PMMA.
- To compare the elution characteristics of oritavancin from PMMA with vancomycin.
- To assess the mechanical integrity of oritavancin-loaded PMMA over time in human plasma.
Main Methods:
- Oritavancin and vancomycin elution from PMMA beads were measured using a human plasma flow system.
- Compressive strength and elastic moduli of bland, oritavancin-loaded, and vancomycin-loaded PMMA were tested after 0, 3, and 7 days of incubation in human plasma.
- Mechanical testing was performed using a servo-hydraulic testing machine under axial compression.
Main Results:
- Oritavancin-loaded PMMA exhibited higher compressive strength on days 3 and 7 compared to vancomycin-loaded PMMA.
- Oritavancin-loaded PMMA demonstrated higher compressive elastic moduli on days 0 and 7 versus vancomycin-loaded PMMA.
- Significantly less oritavancin (1.0%) eluted from PMMA compared to vancomycin (51.9%) after polymerization.
Conclusions:
- Oritavancin-loaded PMMA maintains superior mechanical properties compared to vancomycin-loaded PMMA.
- The reduced elution of oritavancin from PMMA suggests a potentially more sustained local antimicrobial effect.
- Oritavancin represents a promising alternative for antimicrobial PMMA bone cement in orthopedic applications.
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