The effect of antibiotic additions on the fracture properties of bone cements

Two commercially developed cements (Palacos and Zimmer) were tested for fracture toughness with and without gentamicin additions. Compact tension specimens were molded under standardized conditions and divided into four groups. Each group contained specimens of both plain and both antibiotic cements. One group was tested as zero-time controls. The remaining three groups were radiation sterilized. One group was tested as zero-time sterilization controls. Another group was tested after 2 months immersion in Ringer's lactate to elute gentamicin. The last group was tested after being implanted for 2 months subcutaneously in dogs. Comparison of the fracture toughness of the two zero-time groups showed no effect of radiation sterilization on any of the four types of cement. The results from both the group immersed in Ringer's solution and the group implanted in dogs showed no significant effect on fracture toughness with gentamicin additions. Both these groups, however, did have greater toughness values than the zero-time groups, probably caused by the more complete polymerization with time. Furthermore, the Palacos cement exhibited a greater toughness than the Zimmer cement. The results of this study demonstrate that the addition of gentamicin to bone cement is not deleterious to the fracture properties.