Antibiotic Refilling, Antimicrobial Activity, and Mechanical Strength of PMMA Bone Cement Composites Critically Depend on the Processing Technique

2020 ◽  
Vol 6 (7) ◽  
pp. 4024-4035
Author(s):  
Erika L. Cyphert ◽  
Greg D. Learn ◽  
Dylan W. Marques ◽  
Chao-yi Lu ◽  
Horst A. von Recum
2018 ◽  
Vol 3 (4) ◽  
pp. 187-196 ◽  
Author(s):  
Grahmm A. Funk ◽  
Jonathan C. Burkes ◽  
Kimberly A. Cole ◽  
Mohamed N. Rahaman ◽  
Terence E. McIff

Abstract. Introduction: Local delivery of antibiotics using bone cement as the delivery vehicle is an established method of managing implant-associated orthopedic infections. Various fillers have been added to cement to increase antibiotic elution, but they often do so at the expense of strength. This study evaluated the effect of adding a borate bioactive glass, previously shown to promote bone formation, on vancomycin elution from PMMA bone cement.Methods: Five cement composites were made: three loaded with borate bioactive glass along with 0, 1, and 5 grams of vancomycin and two without any glass but with 1 and 5 grams vancomycin to serve as controls. The specimens were soaked in PBS. Eluate of vancomycin was collected every 24 hours and analyzed by HPLC. Orthopedic-relevant mechanical properties of each composite were tested over time.Results: The addition of borate bioactive glass provided an increase in vancomycin release at Day 1 and an increase in sustained vancomycin release throughout the treatment period. An 87.6% and 21.1% increase in cumulative vancomycin release was seen for both 1g and 5g loading groups, respectively. Compressive strength of all composites remained above the weight-bearing threshold of 70 MPa throughout the duration of the study with the glass-containing composites showing comparable strength to their respective controls.Conclusion: The incorporation of borate bioactive glass into commercial PMMA bone cement can significantly increase the elution of vancomycin. The mechanical strength of the cement-glass composites remained above 70 MPa even after soaking for 8 weeks, suggesting their suitability for orthopedic weight-bearing applications.


2019 ◽  
Vol 2 (5) ◽  
pp. 1850-1861 ◽  
Author(s):  
Stefano Perni ◽  
Sergio Caserta ◽  
Rossana Pasquino ◽  
Steve A. Jones ◽  
Polina Prokopovich

2015 ◽  
Vol 490 (1-2) ◽  
pp. 200-208 ◽  
Author(s):  
Ana C. Matos ◽  
Catarina F. Marques ◽  
Rosana V. Pinto ◽  
Isabel A.C. Ribeiro ◽  
Lídia M. Gonçalves ◽  
...  

2011 ◽  
Vol 21 (4) ◽  
pp. 247-258 ◽  
Author(s):  
Hamizah Abd Samad ◽  
Mariatti Jaafar ◽  
Radzali Othman ◽  
Masakazu Kawashita ◽  
Noor Hayati Abdul Razak

2021 ◽  
Vol 12 (1) ◽  
pp. 8
Author(s):  
Erika L. Cyphert ◽  
Ningjing Zhang ◽  
Dylan W. Marques ◽  
Greg D. Learn ◽  
Fang Zhang ◽  
...  

While periprosthetic joint infections (PJIs) result in a small percentage of patients following arthroplasties, they are challenging to treat if they spread into bone and soft tissue. Treatment involves delivering antibiotics using poly(methyl methacrylate) (PMMA) bone cement. However, antibiotic release is insufficient for prolonged infections. Previous work demonstrated efficacy of incorporating insoluble cyclodextrin (CD) microparticles into PMMA to improve antibiotic release and allow for post-implantation drug refilling to occur in a tissue-mimicking model. To simulate how antibiotic refilling may be possible in more physiologically relevant models, this work investigated development of bone and muscle refilling models. The bone refilling model involved embedding PMMA-CD into rabbit femur and administering antibiotic via intraosseous infusion. Muscle tissue refilling model involved implanting PMMA-CD beads in bovine muscle tissue and administering antibiotic via tissue injection. Duration of antimicrobial activity of refilled PMMA-CD was evaluated. PMMA-CD composite in bone and muscle tissue models was capable of being refilled with antibiotics and resulted in prolonged antimicrobial activity. PMMA-CD provided sustained and on-demand antimicrobial activity without removal of implant if infection develops. Intraosseous infusion appeared to be a viable technique to enable refilling of PMMA-CD after implantation in bone, reporting for the first time the ability to refill PMMA in bone.


2006 ◽  
Vol 309-311 ◽  
pp. 797-800 ◽  
Author(s):  
Masami Hashimoto ◽  
Hiroaki Takadama ◽  
Mineo Mizuno ◽  
Tadashi Kokubo ◽  
Koji Goto ◽  
...  

Bioactive bone cement with mechanical properties higher than that of commercial polymethylmethacrylate (PMMA) bone cement are strongly desired to be developed. In the present study, PMMA-based cement incorporated with nano-sized rutile particles was prepared. The PMMA-based cement (rutile content was 50 wt%) shows the compressive strength (136 MPa) higher than that of commercial PMMA bone cement (88 MPa). The hardened cement formed apatite on the surface in a simulated body fluid within 3 days. Therefore, this PMMA-based cement incorporated with rutile particles might be useful as cement for fixation of prostheses as well as self-setting bone substitutes, because of its high apatite forming ability and mechanical strength.


2014 ◽  
Vol 971-973 ◽  
pp. 1013-1016 ◽  
Author(s):  
Yan Lin ◽  
Yong Zhi Xu

All the commercially available plain acrylic bone cement brands, which are used incemented arthroplasties, are based on poly (methyl methacrylate). With a few exceptions, have the same constituents. It is well known that these brands are beset with many drawbacks, such as high maximum exotherm temperature, lack of bioactivity, and volumetric shrinkage upon curing. The aim of this study was to investigate the fatigue properties of MWCNTs-PMMA bone cement composites. Multi-walled carbon nanotubes (unfunctionalised and carboxyl functionalised), which was synthesized by infusion chemical vapor deposition, and PMMA bone cement were used to produce pastes. The mixing amount of MWCNTs ranged from 0.1 wt.% to 1wt.%. The fatigue properties of the MWCNTs-PMMA bone cement was characterised with the type and wt.% loading of MWCNTs used having a significant influence on the number of cycles to failure. The condition and degree of dispersion of the MWCNTs in the matrix at different length scales were studied using field emission scanning electron microscopy. Improvements of the fatigue properties were attributed to the MWCNTs arresting or retarding crack propagation through the cement by a bridging effect and hindering crack propagation. MWCNTs agglomerates were evident in the cement microstructure and the degree of agglomeration depended on the level of the mixing amount and the ability of the MWCNTs.


Polymers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2027
Author(s):  
Jaime Orellana ◽  
Ynés Yohana Pastor ◽  
Fernando Calle ◽  
José Ygnacio Pastor

Bone cement, frequently based on poly (methyl methacrylate), is commonly used in different arthroplasty surgical procedures and its use is essential for prosthesis fixation. However, its manufacturing process reaches high temperatures (up to 120 °C), producing necrosis in the patients' surrounding tissues. To help avoid this problem, the addition of graphene could delay the polymerisation of the methyl methacrylate as it could, simultaneously, favour the optimisation of the composite material's properties. In this work, we address the effect of different percentages of highly reduced graphene oxide with different wt.% (0.10, 0.50, and 1.00) and surface densities (150, 300, 500, and 750 m2/g) on the physical, mechanical, and thermal properties of commercial poly (methyl methacrylate)-based bone cement and its processing. It was noted that a lower sintering temperature was achieved with this addition, making it less harmful to use in surgery and reducing its adverse effects. In contrast, the variation of the density of the materials did not introduce significant changes, which indicates that the addition of highly reduced graphene oxide would not significantly increase bone porosity. Lastly, the mechanical properties (strength, elastic modulus, and fracture toughness) were reduced by almost 20%. Nevertheless, their typical values are high enough that these new materials could still fulfil their structural function. In conclusion, this paper presents a way to control the sintering temperature, without significant degradation of the mechanical performance, by adding highly reduced graphene oxide so that local necrosis of bone cement based on poly (methyl methacrylate) used in surgery is avoided.


2021 ◽  
Vol 1094 (1) ◽  
pp. 012150
Author(s):  
S K Al-Janabi ◽  
M H Al-Maamori ◽  
A J Braihi
Keyword(s):  

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