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Arthroplasty 2019
June 24-25, 2019
Volume 14
Journal of Orthopaedics Trauma Surgery and Related Research
Arthroplasty
June 24-25, 2019 | Rome, Italy
12
th
International Conference on
Anovel approach to improving antibiotic elution from PMMA: How the addition of lipid
affects Gentamicin elution from bone cement
Daniel A Cohen
Prince of Wales Hospital, Australia
A
ntibiotic Poly methyl-methacrylate bone cement (ABC) has a variety of surgical uses including primary and revision
arthroplasty, dead space management in infection and structural support in bone tumours. All of these indications
rely on antibiotic elution to augment systemic antibiotic use. However, in spite of years of research, ABC elutes only a
small percentage of the total antibiotic incorporated. Several techniques and additives have been incorporated into ABC
that improve elution, however this is accompanied by a considerable decrease in mechanical properties. The present study
investigates the additional of a lipid to ABC containing a hydrophilic and moderately lipophilic antibiotic, Gentamicin.
Olive oil was added by weight to Palacos MV+ G bone cement (LL-ABC) which is known for its superior elution properties
in 0, 10 and 20% w/w. Cement was vacuum mixed and placed onto sterilized stainless-steel plates to create small cement
dowels. Antibiotic elution was determined at 4 hours, 1, 3, 7 and 28 days for each concentration. Mechanical properties
of the cement dowels were determined by compressive testing using MTS- bionix 858 with resultant determination of
Young’s modulus and creation of load-deformation curves.
The cumulative antibiotic released (ug/mL) was proportionate to the % w/w of olive added. The cumulative antibiotic
release from the 20% w/w LL-ABC was greater than the control at all time points. At 28 days, 10% and 20% w/w
LL-ABC had released 295% and 585 % more gentamicin than the control sample. Compressive strength and young’s
modulus were inversely related to the concentration of olive oil in the LL-ABC samples.
The addition of olive oil to Gentamicin Palacos MV cement significantly increased the elution potential of the cement
with minor compromise in the mechanical properties. The recommended next step is evaluating whether the locally
eluted antibiotic maintains therapeutic values above the minimal inhibitory concentration and extending this in vitro study
to an in vivo model.
Biography
Dr. Daniel Cohen is a final year orthopaedic surgical registrar (resident) in Sydney, Australia. He was awarded his medical degree
from the University of Sydney in 2010. He also has a Bachelor of Science in Anatomy and a Master of Science in Physiology from
McGill University in Montreal, Canada. He has been actively involved in medical teaching and research with a focus on primary knee
arthroplasty as well as management of complex orthopaedic infections. He has a keen interest in primary and revision hip and knee
arthroplasty and will be undertaking sub-specialty fellowship training in 2020.
dcohen44@hotmail.comDaniel A. Cohen, J.Orthop.Trauma Surg.Relat.Res. | Volume 14
ISSN:2449-9145