NDLI: In vitro study of the efficacy of acrylic bone cement loaded with supplementary amounts of gentamicin: Effect on mechanical properties, antibiotic release, and biofilm formation

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In vitro study of the efficacy of acrylic bone cement loaded with supplementary amounts of gentamicin: Effect on mechanical properties, antibiotic release, and biofilm formation

Content Provider	Taylor & Francis Online
Author	Mcafee, Patricia Dunne, Nicholas Todd, Katy Patrick, Sheila Kirkpatrick, Rachel Tunney, Michael Hill, Janet
Abstract	Background Infection remains a severe complication following a total hip replacement. If infection is suspected when revision surgery is being performed, additional gentamicin is often added to the cement on an ad hoc basis in an attempt to reduce the risk of recurrent infection.Methods and results In this in vitro study, we determined the effect of incorporating additional gentamicin on the mechanical properties of cement. We also determined the degree of gentamicin release from cement, and also the extent to which biofilms of clinical Staphylococcus spp. isolates form on cement in vitro. When gentamicin was added to unloaded cement (1–4 g), there was a significant reduction in the mechanical performance of the loaded cements compared to unloaded cement. A significant increase in gentamicin release from the cement over 72 h was apparent, with the amount of gentamicin released increasing significantly with each additional 1 g of gentamicin added. When overt infection was modeled, the incorporation of additional gentamicin did result in an initial reduction in bacterial colonization, but this beneficial effect was no longer apparent by 72 h, with the clinical strains forming biofilms on the cements despite the release of high levels of gentamicin.Interpretation Our findings indicate that the addition of large amounts of gentamicin to cement is unlikely to eradicate bacteria present as a result of an overt infection of an existing implant, and could result in failure of the prosthetic joint because of a reduction in mechanical performance of the bone cement.
Starting Page	774
Ending Page	785
Page Count	12
File Format	PDF HTM / HTML
ISSN	17453674 17453682
DOI	10.1080/17453670710014545
Journal	Acta Orthopaedica
Volume Number	78
Issue Number	6
Language	English
Publisher	Taylor & Francis
Publisher Date	2009-07-08
Access Restriction	Open
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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