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Antibiotic-impregnated acrylic bone cement

K E Marks, C L Nelson, E P Lautenschlager

    The Journal of Bone and Joint Surgery. American Volume
    |April 1, 1976
    PubMed
    Summary
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    Antibiotic-loaded acrylic bone cements like Simplex and Palacos effectively release antimicrobials. These antibiotic bone cement composites maintain mechanical integrity and provide sustained drug delivery in vivo.

    Area of Science:

    • Biomaterials Science
    • Orthopedic Surgery
    • Infectious Disease

    Background:

    • Acrylic bone cements are widely used in orthopedic surgery.
    • The incorporation of antibiotics into bone cement is a common strategy to prevent or treat bone infections.
    • Understanding the release kinetics and mechanical properties of antibiotic-loaded cements is crucial for clinical efficacy.

    Purpose of the Study:

    • To evaluate the antibacterial and mechanical properties of Simplex and Palacos acrylic bone cements when combined with antibiotics.
    • To compare the antibiotic release profiles of Simplex and Palacos bone cements.
    • To assess the in vivo efficacy of an antibiotic-loaded bone cement composite.

    Main Methods:

    • In vitro testing of antibiotic stability and release from Simplex and Palacos cements.

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  • Mechanical testing (compressive and diametral tension strengths) of antibiotic-cement admixtures.
  • In vivo study in dogs using an oxacillin-Simplex composite to measure antibiotic concentrations in hematomas and bone.

    • Main Results:

    • Acrylic bone cement alone showed no bacteriostatic effect against common bacteria.
    • Oxacillin, cefazolin, and gentamicin remained stable and active when incorporated into the cements.
    • Palacos cement released larger daily amounts of antibiotics for longer durations compared to Simplex.
    • Antibiotic addition did not negatively impact the mechanical strength of the bone cements.
    • In vivo, oxacillin-Simplex composite achieved bactericidal concentrations in surrounding bone for 21 days.

    Conclusions:

    • Antibiotic-loaded acrylic bone cements can effectively deliver antimicrobials with sustained release.
    • Both Simplex and Palacos cements are suitable carriers for antibiotics, with Palacos showing enhanced release.
    • The mechanical properties of the bone cement are not compromised by antibiotic admixture.
    • In vivo studies confirm the prolonged antibacterial activity of antibiotic-loaded bone cement composites.