Surfactant-stabilized emulsion increases gentamicin elution from bone cement

Ryan B. Miller, Alex C. McLaren, Christine M. Leon, Brent Vernon, Ryan McLemore

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Liquid antimicrobial use for antimicrobial-loaded bone cement is limited because of decreased strength and small volume that can be loaded. Emulsifying the liquid antimicrobial into the monomer may address both issues. Questions/purposes: We determined the effect of using a surfactant-stabilized emulsion on antimicrobial release, compressive strength, and porosity. Methods: We made 144 standardized test cylinders from emulsified antimicrobial-loaded bone cement (three batches, 72 cylinders) and control antimicrobial-loaded bone cement made with antimicrobial powder (three batches, 72 cylinders). For each formulation, five specimens per batch (n = 15) were eluted in infinite sink conditions over 30 days for gentamicin delivery; five specimens per batch were axially compressed to failure after elution of 0, 1, and 30 days (n = 45); and two noneluted specimens and two gentamicin delivery specimens from each batch (n = 12) were examined under scanning electron microscopy for porosity. Antimicrobial release and compressive strength were compared across cement type and time using repeated-measures ANOVA. Results: Emulsified antimicrobial-loaded bone cement released four times more antimicrobial than control. Compressive strength of emulsified antimicrobial-loaded bone cement was less than control before elution (58.1 versus 81.3 MPa) but did not decrease over time in elution. Compressive strength of control antimicrobial-loaded bone cement decreased over 30 days in elution (81.3 versus 73.9 MPa) but remained stronger than emulsified antimicrobial-loaded bone cement. Porosity was homogeneous, with pores ranging around 50 μm. Conclusions: Emulsified antimicrobial-loaded bone cement has homogeneous porosity with increased drug release but a large loss of strength. Clinical Relevance: Liquid antimicrobials are released from emulsified antimicrobial-loaded bone cement, but increased strength is needed before this method can be used for implant fixation.

Original languageEnglish (US)
Pages (from-to)2995-3001
Number of pages7
JournalClinical Orthopaedics and Related Research
Volume469
Issue number11
DOIs
StatePublished - Nov 2011

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Bone Cements
Gentamicins
Emulsions
Surface-Active Agents
Compressive Strength
Porosity
Electron Scanning Microscopy
Powders
Analysis of Variance

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Surfactant-stabilized emulsion increases gentamicin elution from bone cement. / Miller, Ryan B.; McLaren, Alex C.; Leon, Christine M.; Vernon, Brent; McLemore, Ryan.

In: Clinical Orthopaedics and Related Research, Vol. 469, No. 11, 11.2011, p. 2995-3001.

Research output: Contribution to journalArticle

Miller, Ryan B. ; McLaren, Alex C. ; Leon, Christine M. ; Vernon, Brent ; McLemore, Ryan. / Surfactant-stabilized emulsion increases gentamicin elution from bone cement. In: Clinical Orthopaedics and Related Research. 2011 ; Vol. 469, No. 11. pp. 2995-3001.
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abstract = "Background: Liquid antimicrobial use for antimicrobial-loaded bone cement is limited because of decreased strength and small volume that can be loaded. Emulsifying the liquid antimicrobial into the monomer may address both issues. Questions/purposes: We determined the effect of using a surfactant-stabilized emulsion on antimicrobial release, compressive strength, and porosity. Methods: We made 144 standardized test cylinders from emulsified antimicrobial-loaded bone cement (three batches, 72 cylinders) and control antimicrobial-loaded bone cement made with antimicrobial powder (three batches, 72 cylinders). For each formulation, five specimens per batch (n = 15) were eluted in infinite sink conditions over 30 days for gentamicin delivery; five specimens per batch were axially compressed to failure after elution of 0, 1, and 30 days (n = 45); and two noneluted specimens and two gentamicin delivery specimens from each batch (n = 12) were examined under scanning electron microscopy for porosity. Antimicrobial release and compressive strength were compared across cement type and time using repeated-measures ANOVA. Results: Emulsified antimicrobial-loaded bone cement released four times more antimicrobial than control. Compressive strength of emulsified antimicrobial-loaded bone cement was less than control before elution (58.1 versus 81.3 MPa) but did not decrease over time in elution. Compressive strength of control antimicrobial-loaded bone cement decreased over 30 days in elution (81.3 versus 73.9 MPa) but remained stronger than emulsified antimicrobial-loaded bone cement. Porosity was homogeneous, with pores ranging around 50 μm. Conclusions: Emulsified antimicrobial-loaded bone cement has homogeneous porosity with increased drug release but a large loss of strength. Clinical Relevance: Liquid antimicrobials are released from emulsified antimicrobial-loaded bone cement, but increased strength is needed before this method can be used for implant fixation.",
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N2 - Background: Liquid antimicrobial use for antimicrobial-loaded bone cement is limited because of decreased strength and small volume that can be loaded. Emulsifying the liquid antimicrobial into the monomer may address both issues. Questions/purposes: We determined the effect of using a surfactant-stabilized emulsion on antimicrobial release, compressive strength, and porosity. Methods: We made 144 standardized test cylinders from emulsified antimicrobial-loaded bone cement (three batches, 72 cylinders) and control antimicrobial-loaded bone cement made with antimicrobial powder (three batches, 72 cylinders). For each formulation, five specimens per batch (n = 15) were eluted in infinite sink conditions over 30 days for gentamicin delivery; five specimens per batch were axially compressed to failure after elution of 0, 1, and 30 days (n = 45); and two noneluted specimens and two gentamicin delivery specimens from each batch (n = 12) were examined under scanning electron microscopy for porosity. Antimicrobial release and compressive strength were compared across cement type and time using repeated-measures ANOVA. Results: Emulsified antimicrobial-loaded bone cement released four times more antimicrobial than control. Compressive strength of emulsified antimicrobial-loaded bone cement was less than control before elution (58.1 versus 81.3 MPa) but did not decrease over time in elution. Compressive strength of control antimicrobial-loaded bone cement decreased over 30 days in elution (81.3 versus 73.9 MPa) but remained stronger than emulsified antimicrobial-loaded bone cement. Porosity was homogeneous, with pores ranging around 50 μm. Conclusions: Emulsified antimicrobial-loaded bone cement has homogeneous porosity with increased drug release but a large loss of strength. Clinical Relevance: Liquid antimicrobials are released from emulsified antimicrobial-loaded bone cement, but increased strength is needed before this method can be used for implant fixation.

AB - Background: Liquid antimicrobial use for antimicrobial-loaded bone cement is limited because of decreased strength and small volume that can be loaded. Emulsifying the liquid antimicrobial into the monomer may address both issues. Questions/purposes: We determined the effect of using a surfactant-stabilized emulsion on antimicrobial release, compressive strength, and porosity. Methods: We made 144 standardized test cylinders from emulsified antimicrobial-loaded bone cement (three batches, 72 cylinders) and control antimicrobial-loaded bone cement made with antimicrobial powder (three batches, 72 cylinders). For each formulation, five specimens per batch (n = 15) were eluted in infinite sink conditions over 30 days for gentamicin delivery; five specimens per batch were axially compressed to failure after elution of 0, 1, and 30 days (n = 45); and two noneluted specimens and two gentamicin delivery specimens from each batch (n = 12) were examined under scanning electron microscopy for porosity. Antimicrobial release and compressive strength were compared across cement type and time using repeated-measures ANOVA. Results: Emulsified antimicrobial-loaded bone cement released four times more antimicrobial than control. Compressive strength of emulsified antimicrobial-loaded bone cement was less than control before elution (58.1 versus 81.3 MPa) but did not decrease over time in elution. Compressive strength of control antimicrobial-loaded bone cement decreased over 30 days in elution (81.3 versus 73.9 MPa) but remained stronger than emulsified antimicrobial-loaded bone cement. Porosity was homogeneous, with pores ranging around 50 μm. Conclusions: Emulsified antimicrobial-loaded bone cement has homogeneous porosity with increased drug release but a large loss of strength. Clinical Relevance: Liquid antimicrobials are released from emulsified antimicrobial-loaded bone cement, but increased strength is needed before this method can be used for implant fixation.

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