Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Labmayr, V; Lerchbaumer, MH; Kuehn, KD; Kittinger, C; Amerstorfer, F; Leithner, A; Glehr, M.
Comparison of elution characteristics and mechanical properties of acrylic bone cements with and without superficial vancomycin coating (SVC) in the late phase of polymerization.
Orthop Traumatol Surg Res. 2021; 107(4): 102908
Doi: 10.1016/j.otsr.2021.102908
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
- Labmayr Viktor
- Co-Autor*innen der Med Uni Graz
- Amerstorfer Florian Ludwig
- Glehr Mathias
- Kittinger Clemens
- Kühn Klaus-Dieter
- Leithner Andreas
- Lerchbaumer Markus Herbert
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- Abstract:
- INTRODUCTION: Antibiotic-loaded bone cements (ALBCs) are used as spacers in two-stage revision arthroplasty for periprosthetic joint infection. We previously described a new technique applying vancomycin powder coating to custom-made cements. To our best knowledge, this method of superficial vancomycin coating (SVC) has not been assessed before. We therefore performed an in-vitro study to determine: (1) whether manually applied SVC strengthened the cements' antibiotic effect; and (2) whether the mechanical requirements for the cements were fulfilled. HYPOTHESIS: SVC increases the antibiotic effect of cement within the first 24hours. METHODS: Cuboid blocks were produced from two commercially available acrylic ALBCs (Palacos R+G and Copal G+V) with and without SVC. Each block was eluted in phosphate-buffered saline at 37°C. Eluates obtained at 1, 2, 3, 4, 5, 10, 15, 30 and 60minutes and 3, 6 and 24hours were evaluated against Staphylococcus aureus (Palacos, Copal) and methicillin-resistant Staphylococcus aureus (MRSA) (Copal) using zone of inhibition tests. Mechanical test results (bending modulus, bending strength) were compared to ISO requirements (≥1800MPa, ≥50MPa). RESULTS: Palacos with SVC produced significantly greater zones of inhibition against Staphylococcus aureus than Palacos without SVC (p=0.002). Copal with SVC showed greater zones of inhibition against both Staphylococcus aureus and MRSA (p=0.002). The antibiotic effect was enhanced by SVC in both cements at every time point within 24hours. The bending modulus and bending strength of Palacos with SVC (2089±166MPa, 60.8±2.6 MPA) and Copal with SVC (2283±195MPa, 56.9±2.4MPa) were significantly above ISO requirements. CONCLUSION: SVC boosts the antibiotic effect of ALBCs in the first 24hours, while maintaining sufficient stability. These findings endorse SVC as a promising additive in septic revision surgery. LEVEL OF EVIDENCE: III; case control study.
- Find related publications in this database (using NLM MeSH Indexing)
- Anti-Bacterial Agents - administration & dosage
- Bone Cements - administration & dosage
- Case-Control Studies - administration & dosage
- Methicillin-Resistant Staphylococcus aureus - administration & dosage
- Polymerization - administration & dosage
- Polymethyl Methacrylate - administration & dosage
- Vancomycin - pharmacology