Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study
Yıl: 2018 Cilt: 29 Sayı: 2 Sayfa Aralığı: 71 - 78 Metin Dili: İngilizce DOI: 10.5606/ehc.2018.59021 İndeks Tarihi: 21-11-2019
Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study
Öz: Objectives: This study aims to compare the antibiotic release and biological effectiveness of bead type and articulating spacers of different cement types with antibiotics added at alternative phases of cement preparation. Materials and methods: Four gram vancomycin was added into two types of antibiotic-free cement (Simplex®, Biomet®) with similar viscosity and also gentamycin-containing cement (Refobacin®). Prepared specimens were used to create cement beads and articulating hip spacers, making a total of six different groups. Two alternative groups were formed by adding the Vancomycin while the cement was in dough phase. Antibiotic release and biological activity were evaluated with immunoassay techniques and agar-disk diffusion methods. Results: All groups showed initial antibiotics surge in the first week, which was 2 to 4 times more evident in the beads group. Antibiotic release and change in release rate were significantly different between Simplexalternative and Simplex, Biomet, Refobacin-beads, and between Biometspacer and Refobacin-beads groups (p<0.05). Elution of antibiotics was not different between mobile spacers prepared with conventional or alternative methods (p>0.05). Biomet cement showed larger diffusion inhibition zone in agar. There was no difference between biological activity of the bead and mobile designs of the Biomet brand (p>0.05). Inhibition zone analyses of agar and disk diffusion tests revealed significant differences between several groups (p<0.05). Conclusion: Cement beads provide superior antibiotic release regardless of cement type or preparation method. Simplex P® cement has lower anti-bacterial efficiency than Biomet®. Different methods for cement and antibiotics mixing and addition of extra vancomycin into the commercially drug loaded cement do not have any effect on the results.
Anahtar Kelime: Konular:
Farklı yöntemlerle hazırlanan boşluk doldurucu ve çimento boncuklarının antibiyotik salınımı ve antibakteriyel etkinliği: In vitro çalışma
Öz: Amaç: Bu çalışmada çeşitli kemik çimentolarına farklı evrelerde eklenen antibiyotiklerle hazırlanan boncuk tipli ve eklem boşluk dolduruculardan antibiyotik salınımı ve biyolojik etkinliği karşılaştırıldı. Gereç ve yöntemler: Benzer viskoziteye sahip iki tip antibiyotiksiz çimentoya (Simplex®, Biomet®) ve gentamisin içeren çimentoya (Refobacin®) 4 gram vankomisin ilave edildi. Çimento boncuklarını ve kalça boşluk doldurucularını oluşturmak için hazırlanan örneklerden toplam altı farklı grup oluşturuldu. Çimento hamur fazında iken vankomisin eklenerek de iki alternatif grup oluşturuldu. Antibiyotik salınımı ve biyolojik aktivite immunoassay teknikleri ve agar-disk difüzyon yöntemleri ile değerlendirildi. Bulgular: Boncuk grubunda 2-4 kat daha fazla olmak üzere tüm gruplarda ilk haftada hızlı antibiyotik salınımı görüldü. Simplexalternatif ile Simplex, Biomet, Refobacin-zincir ve Biomet-boşluk doldurucu ile Refobacin-zincir grupları arasında antibiyotik salınımı ve salınma hızındaki değişim anlamlı olarak farklıydı (p<0.05). Antibiyotiklerin elüsyonu, konvansiyonel veya alternatif yöntemlerle hazırlanan hareketli boşluk doldurucularda farklı değildi (p>0.05). Biomet çimento, agarda daha büyük difüzyon inhibisyon bölgesi gösterdi. Biomet çimento ile hazırlanan boncuk ve hareketli boşluk doldurucularda biyolojik etkinlik farkı yoktu (p>0.05). Agar ve disk difüzyon inhibisyon zonları gruplar arasında anlamlıydı (p<0.05). Sonuç: Çimento boncukları, çimento tipine veya hazırlama yöntemine bakılmaksızın daha fazla antibiyotik salınımı sağlamaktadır. Simplex P® çimento Biomet’den daha düşük anti-bakteriyel verime sahiptir. Farklı yöntemlerle ve farklı zamanlarda vankomisin eklenerek ve karıştırılarak hazırlanan materyallerde ve ticari olarak antibiyotik yüklü çimentoda farklı yöntemlerin sonuçlar üzerinde herhangi bir etkisi yoktur.
Anahtar Kelime: Konular:
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet 2007;370:1508-19.
- Upadhyay A, York S, Macaulay W, McGrory B, Robbennolt J, Bal BS. Medical malpractice in hip and knee arthroplasty. J Arthroplasty 2007;22(6 Suppl 2):2-7.
- Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg [Am] 2007;89:780-5.
- Insall JN, Thompson FM, Brause BD. Two-stage reimplantation for the salvage of infected total knee arthroplasty.J Bone Joint Surg [Am] 1983;65:1087-98.
- Cui Q, Mihalko WM, Shields JS, Ries M, Saleh KJ. Antibiotic impregnated cement spacers for the treatment of infection associated with total hip or knee arthroplasty. J Bone Joint Surg [Am] 2007;89:871-82.
- Hsieh PH, Chen LH, Chen CH, Lee MS, Yang WE, Shih CH. Two-stage revision hip arthroplasty for infection with a custom-made, antibiotic-loaded, cement prosthesis as an interim spacer. J Trauma 2004;56:1247-52.
- Jacobs C, Christensen CP, Berend ME. Static and mobile antibiotic-impregnated cement spacers for the management of prosthetic joint infection. J Am Acad Orthop Surg 2009;17:356-68.
- Garvin KL, Hanssen AD. Infection after total hip arthroplasty. Past, present, and future. J Bone Joint Surg [Am] 1995;77:1576-88.
- Joseph TN, Chen AL, Di Cesare PE. Use of antibioticimpregnated cement in total joint arthroplasty. J Am Acad Orthop Surg 2003;11:38-47.
- Hsieh PH, Shih CH, Chang YH, Lee MS, Shih HN, Yang WE. Two-stage revision hip arthroplasty for infection: comparison between the interim use of antibiotic-loaded cement beads and a spacer prosthesis. J Bone Joint Surg [Am] 2004;86:1989-97.
- Bertazzoni Minelli E1, Benini A, Magnan B, Bartolozzi P. Release of gentamicin and vancomycin from temporary human hip spacers in two-stage revision of infected arthroplasty. J Antimicrob Chemother 2004;53:329-34.
- van de Belt H, Neut D, Uges DR, Schenk W, van Horn JR, van der Mei HC, et al. Surface roughness, porosity and wettability of gentamicin-loaded bone cements and their antibiotic release. Biomaterials 2000;21:1981-7.
- Decoster TA, Bozorgnia S.Antibiotic beads. J Am Acad Orthop Surg 2008;16:674-8.
- Moojen DJ, Hentenaar B, Charles Vogely H, Verbout AJ, Castelein RM, Dhert WJ. In vitro release of antibiotics from commercial PMMA beads and articulating hip spacers. J Arthroplasty 2008;23:1152-6.
- Anagnostakos K, Kelm J, Regitz T, Schmitt E, Jung W. In vitro evaluation of antibiotic release from and bacteria growth inhibition by antibiotic-loaded acrylic bone cement spacers. J Biomed Mater Res B Appl Biomater 2005;72:373-8.
- Anagnostakos K, Wilmes P, Schmitt E, Kelm J. Elution of gentamicin and vancomycin from polymethylmethacrylate beads and hip spacers in vivo. Acta Orthop 2009;80:193-7.
- Hanssen AD, Spangehl MJ. Practical applications of antibiotic-loaded bone cement for treatment of infected joint replacements. Clin Orthop Relat Res 2004;427:79-85.
- Durbhakula SM, Czajka J, Fuchs MD, Uhl RL. Spacer endoprosthesis for the treatment of infected total hip arthroplasty. J Arthroplasty 2004;19:760-7.
- Fehring TK, Odum S, Calton TF, Mason JB. Articulating versus static spacers in revision total knee arthroplasty for sepsis. The Ranawat Award. Clin Orthop Relat Res 2000;380:9-16.
- Evans RP. Successful treatment of total hip and knee infection with articulating antibiotic components: a modified treatment method. Clin Orthop Relat Res 2004;427:37-46.
- Kuechle DK, Landon GC, Musher DM, Noble PC. Elution of vancomycin, daptomycin, and amikacin from acrylic bone cement. Clin Orthop Relat Res 1991;264:302-8.
- Walenkamp GH. Self-mixed antibiotic bone cement: western countries learn from developing countries. Acta Orthop 2009;80:505-7.
- Göçer H, Emir D, Önger ME, Dabak N. Effects of bone cement loaded with teicoplanin, N-acetylcysteine or their combination on Staphylococcus aureus biofilm formation: an in vitro study. Eklem Hastalik Cerrahisi 2017;28:13-8.
- Shiramizu K, Lovric V, Leung AM, Walsh WR. Antibiotic distribution in a bone cement spacer model. Hip Int 2007;17:218-23.
- Miller R, McLaren A, Leon C, McLemore R. Mixing method affects elution and strength of high-dose ALBC: a pilot study. Clin Orthop Relat Res 2012;470:2677-83.
- Shiramizu K, Lovric V, Leung A, Walsh WR. How do porosity-inducing techniques affect antibiotic elution from bone cement? An in vitro comparison between hydrogen peroxide and a mechanical mixer. J Orthop Traumatol 2008;9:17-22.
- Penner MJ, Duncan CP, Masri BA. The in vitro elution characteristics of antibiotic-loaded CMW and Palacos-R bone cements. J Arthroplasty 1999;14:209-14.
- Trippel SB. Antibiotic-impregnated cement in total joint arthroplasty. J Bone Joint Surg [Am] 1986;68:1297-302.
- Greene N, Holtom PD, Warren CA, Ressler RL, Shepherd L, McPherson EJ, Patzakis MJ. In vitro elution of tobramycin and vancomycin polymethylmethacrylate beads and spacers from Simplex and Palacos. Am J Orthop 1998;27:201-5
- Gálvez-López R, Peña-Monje A, Antelo-Lorenzo R, Guardia-Olmedo J, Moliz J, Hernández-Quero J, et al. Elution kinetics, antimicrobial activity, and mechanical properties of 11 different antibiotic loaded acrylic bone cement. Diagn Microbiol Infect Dis 2014;78:70-4.
- Squire MW, Ludwig BJ, Thompson JR, Jagodzinski J, Hall D, Andes D. Premixed antibiotic bone cement: an in vitro comparison of antimicrobial efficacy. J Arthroplasty 2008;23(6 Suppl 1):110-4.
- Chang Y, Chen WC, Hsieh PH, Chen DW, Lee MS, Shih HN, et al. In vitro activities of daptomycin-, vancomycin-, and teicoplanin-loaded polymethylmethacrylate against methicillin-susceptible, methicillin-resistant, and vancomycin-intermediate strains of Staphylococcus aureus. Antimicrob Agents Chemother 2011;55:5480-4.
- Miola M, Bistolfi A, Valsania MC, Bianco C, Fucale G, Verné E. Antibiotic-loaded acrylic bone cements: an in vitro study on the release mechanism and its efficacy. Mater Sci Eng C Mater Biol Appl 2013;33:3025-32.
- Klekamp J, Dawson JM, Haas DW, DeBoer D, Christie M. The use of vancomycin and tobramycin in acrylic bone cement: biomechanical effects and elution kinetics for use in joint arthroplasty. J Arthroplasty 1999;14:339-46.
| APA | ATICI T, ŞAHİN N, ÇAVUN S, Özakın C, Kaleli T (2018). Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. , 71 - 78. 10.5606/ehc.2018.59021 |
| Chicago | ATICI Teoman,ŞAHİN Namık,ÇAVUN Sinan,Özakın Cüneyt,Kaleli Tufan Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. (2018): 71 - 78. 10.5606/ehc.2018.59021 |
| MLA | ATICI Teoman,ŞAHİN Namık,ÇAVUN Sinan,Özakın Cüneyt,Kaleli Tufan Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. , 2018, ss.71 - 78. 10.5606/ehc.2018.59021 |
| AMA | ATICI T,ŞAHİN N,ÇAVUN S,Özakın C,Kaleli T Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. . 2018; 71 - 78. 10.5606/ehc.2018.59021 |
| Vancouver | ATICI T,ŞAHİN N,ÇAVUN S,Özakın C,Kaleli T Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. . 2018; 71 - 78. 10.5606/ehc.2018.59021 |
| IEEE | ATICI T,ŞAHİN N,ÇAVUN S,Özakın C,Kaleli T "Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study." , ss.71 - 78, 2018. 10.5606/ehc.2018.59021 |
| ISNAD | ATICI, Teoman vd. "Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study". (2018), 71-78. https://doi.org/10.5606/ehc.2018.59021 |
| APA | ATICI T, ŞAHİN N, ÇAVUN S, Özakın C, Kaleli T (2018). Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 29(2), 71 - 78. 10.5606/ehc.2018.59021 |
| Chicago | ATICI Teoman,ŞAHİN Namık,ÇAVUN Sinan,Özakın Cüneyt,Kaleli Tufan Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 29, no.2 (2018): 71 - 78. 10.5606/ehc.2018.59021 |
| MLA | ATICI Teoman,ŞAHİN Namık,ÇAVUN Sinan,Özakın Cüneyt,Kaleli Tufan Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), vol.29, no.2, 2018, ss.71 - 78. 10.5606/ehc.2018.59021 |
| AMA | ATICI T,ŞAHİN N,ÇAVUN S,Özakın C,Kaleli T Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2018; 29(2): 71 - 78. 10.5606/ehc.2018.59021 |
| Vancouver | ATICI T,ŞAHİN N,ÇAVUN S,Özakın C,Kaleli T Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study. Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.). 2018; 29(2): 71 - 78. 10.5606/ehc.2018.59021 |
| IEEE | ATICI T,ŞAHİN N,ÇAVUN S,Özakın C,Kaleli T "Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study." Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.), 29, ss.71 - 78, 2018. 10.5606/ehc.2018.59021 |
| ISNAD | ATICI, Teoman vd. "Antibiotic release and antibacterial efficacy in cement spacers and cement beads impregnated with different techniques: In vitro study". Eklem Hastalıkları ve Cerrahisi Dergisi (Eski Adı: Artroplasti Artroskopik Cerrahi Derg.) 29/2 (2018), 71-78. https://doi.org/10.5606/ehc.2018.59021 |
