Rheumatology: Current Research
Open Access
ISSN: 2161-1149 (Printed)
+44-20-4587-4809
ISSN: 2161-1149 (Printed)
+44-20-4587-4809
Bhachu DS, Mallett R and Deb S
Posters: Rheumatology & Orthopedics
W e present a novel method of incorporating Gentamicin into orthopaedic bone cement. Results have shown a reduced peak polymerisation termperature and significantly improved compressive strength compared with bone cement with and without antibiotic incorporation. Background: Antibiotic loaded bone cement (ALBC) was introduced in 1970 as a means to reduce prosthesis related infections1. Antibiotic inclusion into bone cement has been poorly studied and currently factory mixing and intraoperative manual incorporation are the two most common methods used. It has been documented that manual mixing of antibiotics can lead to a significant decline it it?s mechanical properties2. It is postulated that these methods lead to heterogenous distribution of antibiotic which in turn could lead to poor reproducibility of clinical outcomes. Methods: A novel concept of antibiotic incorporation was devised to solve the problem of heterogenous distribution. Gentamicin, a commonly used antibiotic in orthopaedic surgery was combined with ethanol and then combined with the powder component of bone cement (Smartset MV, DePuy) and allowed to dry. The concept is to coat the powder particles of the bone cement with antibiotic in order to achieve a more homogenous distribution. Analysis of the tensile and compressive strengths under dry conditions as well as the thermokinetic properties (dough time, working time and setting time) were performed. Comparisons were made to that of factory produced gentamicin loaded bone cement (Smartset GMV, DePuy) & (Smartset CMW 2000 Gentamicin, DePuy), manually mixed powdered gentamicin with Smartset MV(DePuy) and bone cement without any antibiotic incorporated (Smartset MV, DePuy). Results: Analysis of the ultimate tensile strength (UTS) revealed no statistical difference between the novel cement and it?s comparators. There was however a statistical increase in the compressive strength between the novel cement and Smartset GMV and manually combined Smartset MV with Gentamicin. Peak polymerisation temperature of the novel cement was between 16% and 36% lower than the other cements compared. Discussion: The development of a novel mixing method is yet in its early stages. However initial results reveal promising results which could prove useful in an operative and clinical setting.