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Effect of Ultrasound Frequency and Treatment Duration on Antibiotic Elution from Polymethylmethacrylate Bone Cement

Alexander C Wendling1,2, Damon E Mar1, Jonathan C Burkes1

  • 1University of Kansas Medical Center, Department of Orthopedic Surgery, Kansas City, KS.

Kansas Journal of Medicine
|June 14, 2019
PubMed
Abstract

Insights

Ultrasound treatment significantly enhances antibiotic elution from polymethylmethacrylate (PMMA) bone cement. Higher frequencies (kHz) and longer durations (10 minutes) maximize elution, aiding periprosthetic joint infection treatment.

Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Medical Ultrasound

Background:

  • Polymethylmethacrylate (PMMA) bone cement is widely used in orthopedic surgery.
  • Periprosthetic joint infections (PJIs) are a significant complication requiring effective treatment strategies.
  • Optimizing antibiotic elution from PMMA is crucial for combating PJIs.

Purpose of the Study:

  • To investigate the impact of ultrasound frequency and treatment duration on antibiotic elution from PMMA.
  • To assess the effects of ultrasound on the mechanical properties of antibiotic-impregnated PMMA.
  • To determine optimal ultrasound parameters for enhanced antibiotic delivery.

Main Methods:

  • Vancomycin-loaded PMMA samples were subjected to ultrasound treatment at varying frequencies (kHz vs. MHz) and durations (2 vs. 10 minutes).
  • Antibiotic elution rates were measured daily using flow injection analysis.
  • Mechanical properties (yield stress, modulus) were evaluated using compression testing after elution.
  • Statistical analyses (t-tests, ANOVAs) were employed to determine the significance of ultrasound parameters.

Main Results:

  • All ultrasound treatments significantly increased antibiotic elution compared to controls (p < 0.001).
  • Higher frequencies (kHz) and longer durations (10 minutes) resulted in significantly greater antibiotic elution (p < 0.001).
  • Ultrasound parameters did not significantly affect yield stress but influenced the modulus (p = 0.024 for frequency).

Conclusions:

  • Ultrasound parameters, specifically frequency and duration, significantly modulate antibiotic elution from PMMA.
  • This ultrasound-assisted elution technique shows promise for enhancing the treatment of periprosthetic joint infections during revision arthroplasty.
  • Further research may refine ultrasound protocols for localized antibiotic delivery in orthopedic infections.
Keywords:
anti-bacterial agentsarthroplastyimmunosorbent techniquesprosthesis-related infectionsultrasonography

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