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Arthroplasty 2019

June 24-25, 2019

Volume 14

Journal of Orthopaedics Trauma Surgery and Related Research


June 24-25, 2019 | Rome, Italy



International Conference on

Anovel approach to improving antibiotic elution from PMMA: How the addition of lipid

affects Gentamicin elution from bone cement

Daniel A Cohen

Prince of Wales Hospital, Australia


ntibiotic Poly methyl-methacrylate bone cement (ABC) has a variety of surgical uses including primary and revision

arthroplasty, dead space management in infection and structural support in bone tumours. All of these indications

rely on antibiotic elution to augment systemic antibiotic use. However, in spite of years of research, ABC elutes only a

small percentage of the total antibiotic incorporated. Several techniques and additives have been incorporated into ABC

that improve elution, however this is accompanied by a considerable decrease in mechanical properties. The present study

investigates the additional of a lipid to ABC containing a hydrophilic and moderately lipophilic antibiotic, Gentamicin.

Olive oil was added by weight to Palacos MV+ G bone cement (LL-ABC) which is known for its superior elution properties

in 0, 10 and 20% w/w. Cement was vacuum mixed and placed onto sterilized stainless-steel plates to create small cement

dowels. Antibiotic elution was determined at 4 hours, 1, 3, 7 and 28 days for each concentration. Mechanical properties

of the cement dowels were determined by compressive testing using MTS- bionix 858 with resultant determination of

Young’s modulus and creation of load-deformation curves.

The cumulative antibiotic released (ug/mL) was proportionate to the % w/w of olive added. The cumulative antibiotic

release from the 20% w/w LL-ABC was greater than the control at all time points. At 28 days, 10% and 20% w/w

LL-ABC had released 295% and 585 % more gentamicin than the control sample. Compressive strength and young’s

modulus were inversely related to the concentration of olive oil in the LL-ABC samples.

The addition of olive oil to Gentamicin Palacos MV cement significantly increased the elution potential of the cement

with minor compromise in the mechanical properties. The recommended next step is evaluating whether the locally

eluted antibiotic maintains therapeutic values above the minimal inhibitory concentration and extending this in vitro study

to an in vivo model.


Dr. Daniel Cohen is a final year orthopaedic surgical registrar (resident) in Sydney, Australia. He was awarded his medical degree

from the University of Sydney in 2010. He also has a Bachelor of Science in Anatomy and a Master of Science in Physiology from

McGill University in Montreal, Canada. He has been actively involved in medical teaching and research with a focus on primary knee

arthroplasty as well as management of complex orthopaedic infections. He has a keen interest in primary and revision hip and knee

arthroplasty and will be undertaking sub-specialty fellowship training in 2020.

Daniel A. Cohen, J.Orthop.Trauma Surg.Relat.Res. | Volume 14