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The Bone Matrix

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Bone contains a relatively small number of cells entrenched in a matrix of collagen fibers that provide an adherent surface for inorganic salt crystals. Both components of the matrix, organic and inorganic, contribute to the unusual properties of bone. Without collagen, bones would be brittle and shatter easily. Without mineral crystals, bones would flex and provide little support. This can be observed by an experiment: when the minerals of a bone are dissolved by soaking the bone in...

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Related Experiment Video

Updated: Jul 13, 2025

Treatment with Vancomycin Loaded Calcium Sulphate and Autogenous Bone in an Improved Rabbit Model of Bone Infection

Treatment with Vancomycin Loaded Calcium Sulphate and Autogenous Bone in an Improved Rabbit Model of Bone Infection

Published on: March 14, 2019

[Bone cement as a local antibiotic carrier].

Christof Berberich¹, Klaus-Dieter Kühn^2,3, Volker Alt⁴

¹Heraeus Medical GmbH, Philipp-Reis-Str. 8/11, 61273, Wehrheim, Deutschland. christof.berberich@heraeus.com.

Orthopadie (Heidelberg, Germany)

|October 13, 2023

Summary

Local antibiotics improve musculoskeletal infection treatment by achieving high implant site concentrations with low systemic absorption. This review details optimal antibiotic selection and safe admixing with bone cement for better patient outcomes.

Keywords:

Antibiotic prophylaxis Drug release Drug synergism PMMA Prosthesis related infection

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Area of Science:

Orthopedic Surgery
Infectious Diseases
Pharmacology

Context:

Implant-associated musculoskeletal infections pose significant challenges.
Adjuvant local antimicrobial therapy enhances systemic treatment.
High local antibiotic concentrations at the implant site are crucial.

Purpose:

To review the rationale and evidence for local antibiotic use in musculoskeletal infections.
To guide the selection of antimicrobial agents for local delivery with bone cement.
To address uncertainties regarding antibiotic compatibility and concentrations in polymethylmethacrylate (PMMA) bone cement.

Summary:

Local antibiotics offer superior pharmacokinetics for treating implant-associated infections.
Polymethylmethacrylate (PMMA) bone cement is a common local carrier system.
Optimal antibiotic selection requires collaboration between surgeons and microbiologists, considering antibiograms.

Impact:

Provides evidence-based guidance for optimizing local antibiotic therapy.
Aims to reduce the incidence and improve the treatment of implant-associated infections.
Enhances the safe and effective use of antibiotics admixed with bone cement.