Elution and Biomechanical Properties of Meropenem‐Loaded Bone Cement

Abstract

Objective: To investigate the biomechanical and elution properties of meropenem-loaded bone cement.Methods: Bone cement (Palacos LV) with 5% (2 g/4 0g), 10% (4 g/40 g), and 15% (6 g/40 g) meropenem; 5%(2 g/40 g) and 10% (4 g/40 g) vancomycin; and blank bone cement were prepared in a total of six groups named A2, A4, A6, B2, B4, and A0 (antibiotic-free). 36 cylinder specimens (6-mm diameter and 12-mm height) of all six groups were molded for a compression test. After the compression test, because of mechanical properties below the ISO standard requirements, groups B2, B4 were not subjected to a bending test. So a total of 24 rectangular strip specimens (10-mm width, 75-mm length, and 3.3-mm thickness) for groups A2, A4, A6 and A0 were molded for the bending test. Between-group differences of compressive strength, bending strength and bending modulus were analyzed. The meropenem standard was prepared as a series of standard solutions to calculate the standard curve. At a constant temperature of 37 C, separately, meropenem-loaded bone cement cylinder specimens (12 mm in diameter and 17 mm in length) of A2, A4 and A6 were serially immersed in saline solution without stirring. The eluent drug concentration at 24, 48, 72 h and 6, 12, 24 days was measured and the drug concentration-time curve of meropenem was constructed.Results: With the exception of groups B2 and B4, all cements compressive strength values were well above the minimum requirement of the ISO 5833 standard (70 MPa). The compressive strength and bending strength values of group A4 were higher than those of group A0 (P < 0.05), but no difference was found between the A0, A2 and A6 groups (P > 0.05). There were no intergroup differences of bending modulus between the A0, A2, A4 and A6 groups (P > 0.05). A standard curve of meropenem was obtained and a regression equation was constructed: Y = 15.0265 X + 13.5218, r = 1.00. At 37 C, the release of meropenem was rapid during the first 48 h for all A2, A4, A6 samples, and subsequent release continued to decrease. Conclusion:When adding up to 15% (6 g/40 g) meropenem to the bone cement, the biomechanical properties were not reduced, and bone cement with 10% (4 g/40 g) meropenem had the best performance. At a constant temperature of 37 C, meropenem can be released from bone cement for up to 24 days.

Concomitant Cement Spacer and Peri-spacer Fractures Seven Years After First-stage Revision Knee Arthroplasty: A Case Report

“…Risk factors for peri-spacer fractures include loose spacers, knee varus or valgus malignments, femoral notching, and poor bone quality around the spacer [ 10 ]. Antibiotic choice also affects the biomechanical properties of cement, with vancomycin-loaded bone cement showing favorable properties over cephazolin-loaded bone cement and meropenem-loaded bone cement demonstrating excellent biochemical properties [ 11 ].…”

Mechanically stable rifampin antibiotic cement inhibits Pseudomonas aeruginosa biofilm surface growth

“…Wang et al reported that bone cement remains above the 70 MPa threshold with the addition of up to 6 g of meropenem per 40 g of cement. However, the addition of vancomycin at 2 g/40 g and 4 g/40 g did not retain the 70 MPa threshold 23 . Another study by Slane et al investigated the addition of tobramycin and vancomycin individually and in combination with bone cement.…”