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Gentamycin elution from polymethylmethacrylate and bone graft substitute: Comparison between commercially available
Makrina Karaglani1, Evmorfia Tzitzikou1, Stylianos Tottas2
1Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Abstract:
Polymethylmethacrylate (PMMA) represents the current gold standard as an antibiotic delivery carrier in orthopaedic surgery. Despite the accepted use of local antibiotic carriers, there aren't any conclusive data comparing PMMA to Bone Graft Substitutes. The aim of this in vitro study was to compare the elution profile of gentamicin from various preparations of PMMA cements and Herafill beads. All cements had high initial elution during the first hour which then slowly decreased, Herafill beads on the other hand showed its higher elution around the eighth hour. Herafill, in general, presented the highest elution of gentamicin regardless of its input amount.
Insights
Polymethylmethacrylate (PMMA) and Herafill beads were compared for gentamicin elution. Herafill beads showed higher gentamicin elution overall, particularly around the eighth hour, compared to PMMA cements.
Area of Science:
- Orthopaedic Surgery
- Biomaterials Science
- Pharmacology
Background:
- Polymethylmethacrylate (PMMA) is the standard for antibiotic delivery in orthopaedic surgery.
- Limited comparative data exists between PMMA and bone graft substitutes for antibiotic elution.
- Gentamicin is a common antibiotic used in bone infection prophylaxis and treatment.
Purpose of the Study:
- To compare the in vitro gentamicin elution profiles of PMMA cements and Herafill beads.
- To evaluate the influence of material preparation on antibiotic release.
- To determine which material offers superior gentamicin delivery.
Main Methods:
- In vitro elution study design.
- Preparation of multiple Polymethylmethacrylate (PMMA) cement formulations.
- Preparation of Herafill beads for antibiotic loading.
- Quantification of gentamicin elution over time using established assays.
Main Results:
- Both PMMA cements and Herafill beads exhibited high initial gentamicin elution within the first hour.
- Herafill beads demonstrated a delayed, but higher, peak elution around the eighth hour.
- Herafill generally released the highest amount of gentamicin, irrespective of the initial loading concentration.
Conclusions:
- Herafill beads may offer a more sustained and higher overall gentamicin release compared to PMMA cements.
- The elution characteristics of PMMA and Herafill differ significantly, suggesting distinct clinical applications.
- Further in vivo studies are warranted to confirm these findings and assess clinical efficacy.
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