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Published on: March 14, 2019
The Impact of Different Radiopacifying Agents on the Elution and Mechanical Properties of Vancomycin-loaded Bone
Arezou Mashak1, Mohammad Atai2, Azizollah Nodehi2
1Iran Polymer and Petrochemical Institute, P.O. Box: 14965/115, Tehran, Iran. a.mashak@ippi.ac.ir.
Abstract:
Antibiotic-loaded poly methyl methacrylate (PMMA) bone cements are used as one of the most effectual means to prevent orthopedic-implant associated infections. In the development of the orthopedic implants containing antibiotics, the drug elution behavior is of great importance. PMMA is radiolucent and mineral radiopacifying agents are commonly used to provide sufficient radiopacity. In this study, calcium tungstate, bismuth oxychloride, and barium sulfate as radio-opacifying agents are incorporated into Vancomycin (Vanco)-loaded PMMA bone cements. The effect of Vanco content and different type of radiopacifier on the handling properties, in vitro Vanco elution profiles, morphology, contact angle, mechanical, and antimicrobial properties of the prepared bone cements are evaluated. The results show that the Vanco elution profiles are influenced by the composition and wettability of the cement surface. It is observed that, after 21 days, the released vancomycin from the sample containing 7% Vanco with higher wettability increased approximately six fold compared to the sample with 1% Vanco. The sample containing bismuth oxychloride exhibited higher contact angle resulting in a reduced vancomycin release rate. Consequently, the drug elution and antibacterial activity of the cements depend on the drug content than the type of radiopacifying agents. Our findings introduce alternative radiopacifying agents for the cements and provide an insight into the elution behavior of Vanco in the cements.
Insights
This study explores antibiotic-loaded bone cements for preventing infections. Vancomycin elution is key, influenced by radiopacifiers and cement wettability, impacting antibacterial effectiveness.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Infectious Disease Prevention
Background:
- Antibiotic-loaded poly methyl methacrylate (PMMA) bone cements are crucial for preventing orthopedic-implant infections.
- Optimizing antibiotic elution from PMMA bone cements is vital for efficacy.
- PMMA's radiolucency necessitates radiopacifying agents for implant visibility.
Purpose of the Study:
- To investigate the impact of radiopacifying agents (calcium tungstate, bismuth oxychloride, barium sulfate) on Vancomycin (Vanco)-loaded PMMA bone cements.
- To evaluate how Vanco content and radiopacifier type affect cement properties, including drug elution, handling, morphology, mechanical, and antimicrobial characteristics.
- To understand the relationship between cement surface wettability and Vanco release kinetics.
Main Methods:
- Incorporation of calcium tungstate, bismuth oxychloride, and barium sulfate into Vanco-loaded PMMA bone cements.
- Evaluation of handling properties, in vitro Vanco elution profiles over 21 days.
- Assessment of cement morphology, contact angle, mechanical strength, and antimicrobial activity.
Main Results:
- Vancomycin elution profiles were significantly influenced by cement composition and surface wettability.
- Higher Vanco content (7%) and increased wettability led to a six-fold increase in drug release compared to 1% Vanco after 21 days.
- Bismuth oxychloride resulted in a higher contact angle and reduced Vanco release rate.
- Overall drug elution and antibacterial activity were primarily dependent on Vanco content rather than the specific radiopacifying agent used.
Conclusions:
- Alternative radiopacifying agents can be successfully incorporated into Vanco-loaded PMMA bone cements.
- Cement wettability plays a critical role in modulating antibiotic elution behavior.
- Vancomycin content is the dominant factor influencing both drug release and antibacterial efficacy in these bone cements.
