Abstract:

BACKGROUND: In artificial joint replacement surgery, which antibiotic mixed with bone cement can play an effective prevention against postoperative infection is still controversial.
OBJECTIVE: To study the release characteristics of antibiotic in animals and the mechanical properties of bone cement based on the observation of bone cement mixed with different antibiotics using different mixture methods.
METHODS: Thirty-six white rabbits were randomly divided into six groups: gentamicin group Ⅰ, vancomycin group Ⅰ, cefuroxime sodium group Ⅰ, gentamicin group Ⅱ, vancomycin group Ⅱ, cefuroxime sodium group Ⅱ. In the former three groups, 2 g of gentamicin sulfate, 1 g of vancomycin and 1.5 g of cefuroxime sodium were added into 40 g of bone cement at different phases, respectively, to prepare antibiotic-loaded bone cements that were then implanted into the rabbits. In the latter three groups, 2 g of gentamicin sulfate, 1 g of vancomycin and 1.5 g of cefuroxime sodium were respectively added before the solid-phase and liquid-phase mixture of 40 g bone cement.
RESULTS AND CONCLUSION: The average release time of three antibiotics was over 31 days in rabbits. The elution volume of antibiotics in the former three groups was higher than that in the latter three groups (P < 0.05). The elution volume in the vancomycin group Ⅰ was higher than that in the other groups (P < 0.05). The mechanical properties of antibiotic-loaded bone cements in each group were better than international standard ISO 5833, and there was no significant difference among the groups. These findings indicate that antibiotics can release from bone cement effectively; bone cements containing 1-2 g of antibiotics cannot affect the mechanical strength of bone cements; the elution effect of vancomycin is better; the method to add antibiotics after the solid-phase and liquid-phase bone cement mixture is more conducive to the release of antibiotics.