Mixing method affects elution and strength of high-dose ALBC: a pilot study.

Clinical Orthopaedics and Related Research
Ryan B MillerRyan McLemore

Abstract

High-dose antimicrobial-loaded bone cement (ALBC) is used to treat orthopaedic infections. High-dose ALBC is not commercially available and requires surgeon directed formulation, and there are several different methods used to mix high-dose ALBC. We asked whether the mixing method affected antimicrobial elution and mechanical properties of high-dose ALBC. ALBC was formulated with Simplex P bone cement and 10 g of vancomycin per batch using one of three mixing methods: (1) hand-stirred using a standard bowl and spatula, (2) bowl-mixed using a mechanical mixing bowl, and (3) dough-phase mixing where the vancomycin was left in chunks (1-5 mm) and folded into the cement during the dough phase after adding the monomer. We eluted 45 standardized test cylinders (15 per mixing technique) for 30 days under infinite sink conditions. We tested 135 (45 per mixing method) similarly eluted cylinders in axial compression to failure. Dough-phase mixing lead to greater antimicrobial delivery, but lower compressive strength than the hand-stirred or bowl-mixed methods. Dough-phase cement released 18,570 lg of vancomycin versus 11,731 for hand-stirred and 7700 μg for bowl mixed. Compressive strength for dough-phase mixing after 30 days of elution ...Continue Reading

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Feb 18, 2010·Clinical Orthopaedics and Related Research·Matt NugentRyan McLemore

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Citations

Feb 11, 2014·Clinical Orthopaedics and Related Research·Alex McLarenRyan McLemore
Aug 31, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Rajiv GandhiMichael G Zywiel
Feb 15, 2019·Journal of Materials Science. Materials in Medicine·Sebastian P BoelchMartin Luedemann
Oct 25, 2013·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Morgan B GiersRyan McLemore
Jan 28, 2014·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Claudio Diaz-LedezmaIrving Shapiro
Sep 18, 2014·Clinical Orthopaedics and Related Research·Derek OverstreetRyan McLemore
Aug 11, 2017·Clinical Orthopaedics and Related Research·Jae Hoo LeeKwan Kyu Park
Nov 13, 2018·Journal of Bone and Joint Infection·Grahmm A FunkTerence E McIff
Oct 10, 2015·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Daniel O KendoffHans Bösebeck
May 24, 2017·Journal of Materials Science. Materials in Medicine·Sebastian P BoelchAndre F Steinert
Jul 12, 2012·Clinical Orthopaedics and Related Research·Ryan B MillerRyan McLemore
Nov 2, 2012·Journal of Biomedical Materials Research. Part a·Derek J OverstreetBrent L Vernon
Apr 11, 2019·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Mitsuru HanadaYukihiro Matsuyama
Mar 7, 2020·Clinical Orthopaedics and Related Research·Ayesha Abdeen
Feb 13, 2020·The Journal of Arthroplasty·Brandon H Naylor, Giles R Scuderi

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