Elution Characteristics of Antibiotics in Vancomycin Impregnated Bone Cement

Tae Young Kwon; Kwang Bok Lee

Tae Young Kwon Department of Orthopaedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
Kwang Bok Lee Department of Orthopaedic Surgery, Research Institute of Clinical Medicine of Jeonbuk National University- Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea

Abstract

Treatment of osteomyelitis and prosthesis infections in the orthopedic area presents a difficult problem. Currently, Antibiotics impregnated bone cement made of Polymethyl methacrylate (PMMA) and calcium phosphate cement (CPC) has been used as a local treatmentof osteomyelitis. The characteristics of the dissolution of the antibiotic between CPC and PMMA has not been investigated. The purpose of this study is to compare the antibiotics release patterns of different cement types. We compared VCM concentrations in eluates from CPC (Novoset®; CBBio, Seoul, Korea) to those in eluates from 2 PMMA (Biomet Palacos®; Biomet Orthopaedics, Kerzer, Switzerland and Depuy CMW3®; DePuy International Ltd., England). The eluates were obtained on days 1, 2, 3, 7, and weeks 2, 3 and 4. HPLC (high-performance liquid chromatography) was applied to calculate the concentrations of VCM in thawed eluates of 3 groups, according to a Korean Pharmacopoeia vancomycin hydrochloride dissolution test method. The concentration of VCM eluted in CPC/VCM was maximum on day 1(595.81 μg VCM/ml), after which it showed a decreasing trend, but it continued to elute until the last observation. Compared with PMMA products, CPC/VCM released a large amount of antibiotics from day 1 to day 7, especially from day 1 to day 3, showing more than 15 times the amount of release. In addition, only a small amount of antibiotics was released in all samples after 2 weeks. CPC (Novoset) showed that the elution amount of antibiotics (VCM) was superior when compared to PMMA products. In addition, the dissolution persistence showed similar tendency between CPC and other PMMA cement products.

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