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Strength of Antimicrobial Bone Cement Decreases with Increased Poragen Fraction

  • Symposium: Papers Presented at the 2009 Meeting of the Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Adding soluble particulate poragens to antimicrobial-loaded bone cement increases the permeability of the bone cement and increases the antimicrobial release, but the mechanical effect of adding poragens is not well known.

Questions/purposes

We therefore asked the following questions: (1) Does the poragen fraction in antimicrobial-loaded bone cement affect its antimicrobial release? (2) Does poragen fraction in antimicrobial-loaded bone cement affect its compressive strength; and (3) Does the effect on compressive strength change over time in elution?

Methods

Antimicrobial-loaded bone cement made in the proportions of 40 g polymer powder, 20 mL monomer liquid, 1 g tobramycin powder and one of six different doses of poragen powder (0, 1, 2, 4, 8, or 16 g of particulate xylitol per batch) was formed into standardized test cylinders and eluted for 30 days. We determined the cumulative recovered tobramycin and the change in compressive strength over 30 days of elution.

Results

Antimicrobial release progressively increased with increasing poragen fraction. Compressive strength progressively decreased with increasing poragen fraction and with increasing time in elution. Poragen fractions greater than 2 g per batch caused the compressive strength to decrease below 70 MPa over 30 days of elution.

Clinical Relevance

The use of poragens can increase elution of antimicrobials from antimicrobial-loaded bone cement. However, for implant fixation, to avoid deleterious reduction of compressive strength, the amount of poragen that can be added in addition to 1 g of antimicrobial powder may be limited to 2 g per batch.

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Acknowledgments

We thank Himanshu Kaul BSE for assistance with this study.

Author information

Authors and Affiliations

  1. Banner Good Samaritan Medical Center, 1300 N 12th Street, Suite 620, Phoenix, AZ, 85006, USA

    Matt Nugent MD, Alex McLaren MD & Ryan McLemore PhD

  2. Center for Interventional Biomaterials, Harrington Department of Bioengineering, School of Biological and Health Systems Engineering, Arizona State University, Phoenix, AZ, USA

    Alex McLaren MD, Brent Vernon PhD & Ryan McLemore PhD

Authors
  1. Matt Nugent MD
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  2. Alex McLaren MD
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  3. Brent Vernon PhD
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  4. Ryan McLemore PhD
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Corresponding author

Correspondence to Ryan McLemore PhD.

Additional information

All the authors received funding from the Herbert T. Lewis Fund in the Orthopaedic Research and Education Foundation.

This work was performed at Banner Good Samaritan Medical Center, Phoenix AZ and the Center for Interventional Biomaterials, Arizona State University, Tempe AZ.

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Nugent, M., McLaren, A., Vernon, B. et al. Strength of Antimicrobial Bone Cement Decreases with Increased Poragen Fraction. Clin Orthop Relat Res 468, 2101–2106 (2010). https://doi.org/10.1007/s11999-010-1264-1

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  • DOI: https://doi.org/10.1007/s11999-010-1264-1

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