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Diagn Microbiol Infect Dis. 2015 Oct;83(2):203-9. doi: 10.1016/j.diagmicrobio.2015.06.019. Epub 2015 Jul 2.

Increased antibiotic release and equivalent biomechanics of a spacer cement without hard radio contrast agents.

Author information

1
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a 69118, Heidelberg, Germany. Electronic address: Rudi.Bitsch@med.uni-heidelberg.de.
2
Laboratory of Biomechanics and Implant Research, Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a 69118, Heidelberg, Germany.
3
Heraeus Medical GmbH, 61273 Wehrheim, Germany.
4
Klinikum Mittelbaden, 76530 Baden-Baden, Germany.
5
Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, Schlierbacher Landstrasse 200a 69118, Heidelberg, Germany.

Abstract

We compared a novel calcium carbonate spacer cement (Copal® spacem) to well-established bone cements. Electron microscopic structure and elution properties of the antibiotics ofloxacin, vancomycin, clindamycin, and gentamicin were examined. A knee wear simulator model for articulating cement spacers was established. Mechanical tests for bending strength, flexural modulus, and compressive and fatigue strength were performed. The electron microscopic analysis showed a microporous structure of the spacer cement, and this promoted a significantly higher and longer antibiotic elution. All spacer cement specimens released the antibiotics for a period of up to 50days with the exception of the vancomycin loading. The spacer cement showed significantly less wear scars and fulfilled the ISO 5833 requirements. The newly developed spacer cement is a hydrophilic antibiotic carrier with an increased release. Cement without hard radio contrast agents can improve tribological behaviour of spacers, and this may reduce reactive wear particles and abrasive bone defects.

KEYWORDS:

Antibiotic loading; Cement spacer; Compression strength; Elution kinetics; Tribological wear analysis

[Indexed for MEDLINE]

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