Routine Use of Antibiotic Laden Bone Cement for Primary Total Knee Arthroplasty: Impact on Infecting Microbial Patterns and Resistance Profiles

Hansen, Erik N.; Adeli, Bahar; Kenyon, Robert F.; Parvızı, Javad

doi:10.1016/j.arth.2013.12.004

Cited by 74 publications

(54 citation statements)

References 19 publications

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“…Polymerization is an exothermic reaction and is the leading cause for bone damage at the interface between bone cement and bone. 41 Parabens are thermally stable 42 and, therefore, temperature alone cannot be responsible for such decreased activity; however, radicals can interact with the paraben molecules and cause these molecules degradation, thus the active quantity Perni et al Gentamicin and tobramycin are the most common antibiotics used in PMMA bone cement 43 in virtue of their thermal stability and broad spectrum; they are effective against β-lactam resistant strains such as MRSA. However, S. epidermidis strains such as RP62a and various remaining after bone cement settling is lower than the initial amount, requiring a greater quantity in PMMA bone cement to achieve the same results as in CPC.…”

Section: Parabens Uses and Safetymentioning

confidence: 99%

Antimicrobial activity of bone cements embedded with organic nanoparticles

Perni¹,

Thenault²,

Abdo³

et al. 2015

IJN

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Infections after orthopedic surgery are a very unwelcome outcome; despite the widespread use of antibiotics, their incidence can be as high as 10%. This risk is likely to increase as antibiotics are gradually losing efficacy as a result of bacterial resistance; therefore, novel antimicrobial approaches are required. Parabens are a class of compounds whose antimicrobial activity is employed in many cosmetic and pharmaceutical products. We developed propylparaben nanoparticles that are hydrophilic, thus expanding the applicability of parabens to aqueous systems. In this paper we assess the possibility of employing paraben nanoparticles as antimicrobial compound in bone cements. The nanoparticles were embedded in various types of bone cement (poly(methyl methacrylate) [PMMA], hydroxyapatite, and brushite) and the antimicrobial activity was determined against common causes of postorthopedic surgery infections such as: Staphylococcus aureus , methicillin-resistant S. aureus , Staphylococcus epidermidis , and Acinetobacter baumannii . Nanoparticles at concentrations as low as 1% w/w in brushite bone cement were capable of preventing pathogens growth, 5% w/w was needed for hydroxyapatite bone cement, while 7% w/w was required for PMMA bone cement. No detrimental effect was determined by the addition of paraben nanoparticles on bone cement compression strength and cytocompatibility. Our results demonstrate that paraben nanoparticles can be encapsulated in bone cement, providing concentration-dependent antimicrobial activity; furthermore, lower concentrations are needed in calcium phosphate (brushite and hydroxyapatite) than in acrylic (PMMA) bone cements. These nanoparticles are effective against a wide spectrum of bacteria, including those already resistant to the antibiotics routinely employed in orthopedic applications, such as gentamicin.

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Section: Parabens Uses and Safetymentioning

confidence: 99%

Antimicrobial activity of bone cements embedded with organic nanoparticles

Perni¹,

Thenault²,

Abdo³

et al. 2015

IJN

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“…Esta alta resistencia es la principal causa de que de las terapias antimicrobianas profilácticas fallen en la prevención de IPA 36 . En un estudio multicéntrico publicado por Tornero et al 37 donde se describe la resistencia en S. aureus y S. epidermidis aislados de IPA entre 1999 y 2009, se encontró que aproximadamente el 9% de los S. aureus eran resistentes a meticilina, mientras que la resistencia para este mismo antibiótico en S. epidermidis fue del 60%; la resistencia para fluoroquinolonas en estas bacterias fue del 16% y del 35%, respectivamente.…”

Section: Discussionunclassified

Características microbiológicas y patrones de resistencia en infecciones de prótesis articular en un hospital de referencia

Ortega‐Peña

Colín-Castro

Hernández‐Durán

et al. 2015

Cirugía y Cirujanos

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“…However, it was demonstrated that routine use of ALBC does not change the PJI rate, though it may be useful in the reduction of the PJI rate in high-risk patients (for example those with diabetes or immunosuppression). 33,34 …”

Section: Intra-operative Factorsmentioning

confidence: 99%

Total knee arthroplasty and infection: how surgeons can reduce the risks

Ratto

Rosso³

et al. 2016

EFORT Open Reviews

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Total joint arthroplasty (TJA) is one of the most common orthopaedic procedures. Nevertheless, several complications can lead to implant failure.Peri-prosthetic joint infections (PJI) certainly represent a significant challenge in TJA, constituting a major cause of prosthetic revision. The surgeon may have an important role in reducing the PJI rate by limiting the impact of significant risk factors associated to either the patient, the operative environment or the post-operative care.In the pre-operative period, several preventive measures may be adopted to manage reversible medical comorbidities. Other recognised pre-operative risk factors are urinary tract infections, intra-articular corticosteroid injections and nasal colonisation with Staphylococcus (S.) aureus, particularly the methicillin-resistant strain (MRSA).In the intra-operative setting, protective measures for PJI include antibiotic prophylaxis, surgical-site antisepsis and use of pre-admission chlorhexidine washing and pulsed lavage during surgery. In this setting, the use of plastic adhesive drapes and sterile stockinette, as well as using personal protection systems, do not clearly reduce the risk of infection. On the contrary, using sterile theatre light handles and splash basins as well as an increased traffic in the operating room are all associated with an increased risk for PJI.In the post-operative period, other infections causing transient bacteraemia, blood transfusion and poor wound care are considered as risk factors for PJI.Cite this article: Ratto N, Arrigoni C, Rosso F, Bruzzone M, Dettoni F, Bonasia DE, Rossi R. Total knee arthroplasty and infection: how surgeons can reduce the risks. EFORT Open Rev 2016;1: 339-344 DOI: 10.1302/2058-5241.1.000032.

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Routine Use of Antibiotic Laden Bone Cement for Primary Total Knee Arthroplasty: Impact on Infecting Microbial Patterns and Resistance Profiles

Cited by 74 publications

References 19 publications

Antimicrobial activity of bone cements embedded with organic nanoparticles

Antimicrobial activity of bone cements embedded with organic nanoparticles

Características microbiológicas y patrones de resistencia en infecciones de prótesis articular en un hospital de referencia

Total knee arthroplasty and infection: how surgeons can reduce the risks

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