Elution and Mechanical Strength of Vancomycin-Loaded Bone Cement: In Vitro Study of the Influence of Brand Combination.
Elution and Mechanical Strength of Vancomycin-Loaded Bone Cement: In Vitro Study of the Influence of Brand Combination.
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DOI：
10.1371/journal.pone.0166545
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Hsieh PH
中科院分区：
文献类型：
--
作者：
Lee SH;Tai CL;Chen SY;Chang CH;Chang YH;Hsieh PH
抗生素骨水泥（ALBC）广泛应用于骨科手术，用于预防和治疗感染。关于不同品牌的抗生素和骨水泥组合对ALBC的洗脱曲线和机械强度的影响知之甚少。标准化样本由4种品牌的骨水泥和3种品牌的万古霉素组成，产生12种ALBC组合。使用40 g骨水泥中的两种万古霉素剂量代表高（4 g万古霉素）和低（1 g万古霉素）剂量组。测量从ALBC洗脱的万古霉素浓度长达336小时。在洗脱前后使用材料试验机在轴向压缩下测试极限压缩强度。在高剂量和低剂量组中，PALACOS骨水泥中的Lyo-Vancin导致最高的累积洗脱，Simplex P骨水泥中的Vanco导致最低的洗脱（高剂量组和低剂量组分别高出458%和65%）。在所有低剂量万古霉素组中，机械强度均未受到显著影响（洗脱后范围：70.31 ± 2.74 MPa至87.28 ± 8.26 MPa）。然而，随着高剂量万古霉素的加入，骨水泥老化后极限抗压强度有不同程度的降低，范围为5%（Simplex P中的Vanco，洗脱后81.10 ± 0.48 MPa）至38%（CMW中的无菌万古霉素，洗脱后60.94 ± 5.74 MPa）。我们得出结论，万古霉素和骨水泥品牌的选择对ALBC的释放效率和机械强度有很大影响。
Antibiotic-loaded bone cement (ALBC) is widely used in orthopaedic surgery for both prevention and treatment of infection. Little is known about the effect of different brand combinations of antibiotic and bone cement on the elution profile and mechanical strength of ALBC. Standardized specimens that consisted of one of the 4 brands of bone cement and one of the 3 brands of vancomycin were fashioned, producing 12 combinations of ALBC. Two dosages of vancomycin in 40g bone cement were used to represent the high (4g vancomycin) and low (1g vancomycin) dose groups. Concentrations of vancomycin elution from ALBC was measured for up to 336 hours. The ultimate compression strength was tested at axial compression using a material testing machine before and after elution. In both high-dose and low-dose groups, Lyo-Vancin in PALACOS bone cement resulted in the highest cumulative elution and Vanco in Simplex P bone cement resulted in the lowest elution (458% and 65% higher in high- and low-dose groups, respectively). The mechanical strength was not significantly compromised in all groups with low dose vancomycin (range: 70.31 ± 2.74 MPa to 87.28 ± 8.26MPa after elution). However, with the addition of high dose vancomycin, there was a mixed amount of reduction in the ultimate compression strength after cement aging, ranging from 5% (Vanco in Simplex P, 81.10 ± 0.48 MPa after elution) to 38% (Sterile vancomycin in CMW, 60.94 ± 5.74 MPa after elution). We concluded that the selection of brands of vancomycin and bone cement has a great impact on the release efficacy and mechanical strength of ALBC.