TY - JOUR
T1 - Hand-mixed and premixed antibiotic-loaded bone cement have similar homogeneity
AU - McLaren, Alex C.
AU - Nugent, Matt
AU - Economopoulos, Kostas
AU - Kaul, Himanshu
AU - Vernon, Brent
AU - McLemore, Ryan
N1 - Funding Information:
This work was supported by a grant from OREF and funds from Banner Health. Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. This work was performed at Arizona State University, Phoenix, AZ.
PY - 2009/7
Y1 - 2009/7
N2 - Since low-dose antibiotic-loaded bone cement (ALBC) was approved by the FDA for second-stage reimplantation after infected arthroplasties in 2003, commercially premixed low-dose ALBC has become available in the United States. However, surgeons continue to mix ALBC by hand. We presumed hand-mixed ALBC was not as homogeneous as commercially premixed ALBC. We assessed homogeneity by determining the variation in antibiotic elution by location in a batch, from premixed and hand-mixed formulations of low-dose ALBC. Four hand-mixed methodologies were used: (1) suspension-antibiotic powder in the liquid monomer; (2) no-mix-antibiotic powder added but not mixed with the polymer powder before adding monomer; (3) hand-stirred-antibiotic powder stirred into the polymer powder before the monomer was added; and (4) bowl-mix-antibiotic powder mixed into polymer powder using a commercial mixing bowl before the monomer was added. Antibiotic elution was measured using the Kirby-Bauer bioassay. None of the mixing methods had consistently dissimilar homogeneity of antibiotic distribution from the others. Based upon our data we conclude hand-mixed low-dose ALBC is not less homogeneous than commercially premixed formulations.
AB - Since low-dose antibiotic-loaded bone cement (ALBC) was approved by the FDA for second-stage reimplantation after infected arthroplasties in 2003, commercially premixed low-dose ALBC has become available in the United States. However, surgeons continue to mix ALBC by hand. We presumed hand-mixed ALBC was not as homogeneous as commercially premixed ALBC. We assessed homogeneity by determining the variation in antibiotic elution by location in a batch, from premixed and hand-mixed formulations of low-dose ALBC. Four hand-mixed methodologies were used: (1) suspension-antibiotic powder in the liquid monomer; (2) no-mix-antibiotic powder added but not mixed with the polymer powder before adding monomer; (3) hand-stirred-antibiotic powder stirred into the polymer powder before the monomer was added; and (4) bowl-mix-antibiotic powder mixed into polymer powder using a commercial mixing bowl before the monomer was added. Antibiotic elution was measured using the Kirby-Bauer bioassay. None of the mixing methods had consistently dissimilar homogeneity of antibiotic distribution from the others. Based upon our data we conclude hand-mixed low-dose ALBC is not less homogeneous than commercially premixed formulations.
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U2 - 10.1007/s11999-009-0847-1
DO - 10.1007/s11999-009-0847-1
M3 - Article
C2 - 19390905
AN - SCOPUS:67649798547
SN - 0009-921X
VL - 467
SP - 1693
EP - 1698
JO - Clinical Orthopaedics and Related Research
JF - Clinical Orthopaedics and Related Research
IS - 7
ER -