Sedit Kıvanç MURATLI, Vasfi KARATOSUN, Bora UZUN, İzge GÜNAL

Biomechanical comparison of tigecycline loaded bone cement with vancomycin and daptomycin loaded bone cements

Objective: The objectives of this study were “1” to analyze the compressive and tensile mechanical strength characteristics of tigecycline loaded bone cement and “2” to compare them with those of vancomycin and daptomycin loaded bone cements which are used in prosthetic joint infections complicated with resistant microorganisms.Methods: In this study, three experimental groups, which consisted of vancomycin (subgroups containing 1 g, 2 g, and 3 g vancomycin), daptomycin (subgroups containing 0.5 g, 1 g, and 1.5 g daptomycin), and tigecycline (subgroups containing 50 mg, 100 mg, and 150 mg tigecycline) and one control group without antibiotics were used. Using a standardized protocol, all antibiotic loaded bone cements were prepared. For each antibiotic group, including the control group, 10 samples were tested. All samples were biomechanically tested in terms of compressive strength and tensile strength.Results: Compression tests showed that all determined antibiotic concentrations resulted in a significant decrease when compared with the control group (p

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1. Joseph TN, Chen AL, Di Cesare PE. Use of antibiotic-impregnated cement in total joint arthroplasty. J Am Acad Orthop Surg 2003; 11: 38-47. [Crossref]

2. Trampuz A, Zimmerli W. Antimicrobial agents in orthopaedic surgery: Prophylaxis and treatment. Drugs 2006; 66: 1089-105. [Crossref]

3. Bosco JA, Bookman J, Slover J, Edusei E, Levine B. Principles of antibiotic prophylaxis in total joint arthroplasty: Current concepts. J Am Acad Orthop Surg 2015; 23: 27-35. [Crossref]

4. Witso E. Infections in Orthopaedics. In: Bentley G, editor. European Surgical Orthopaedics and Traumatology, The EFORT Textbook Vol 1. New York-Dordrecht-London: Springer Heidelberg; 2014: 331-63. [Crossref]

5. Zahar A. Local Antibiotic Therapy: Antibiotic-Loaded Cement. In Kendoff D, Morgan-Jones R, Haddad FS, editors. Periprosthetic Joint Infections "Changing Paradigms". Switzerland: Springer International Publishing; 2016:115-132. [Crossref]

6. Nichol T, Smith TJ, Townsend R, Stockley I, Akid R. Analysis of linezolid and tigecycline as candidates for local prophylaxis via antibiotic-loaded bone cement. J Antimicrob Chemother. 2017; 72: 410-6. [Crossref]

7. Kreis CA, Raschke MJ, Roßlenbroich SB, Tholema-Hans N, Löffler B, Fuchs T. Therapy of intracellular Staphylococcus aureus by tigecyclin. BMC Infect Dis 2013; 13: 267. doi: 10.1186/1471-2334-13-267. [Crossref]

8. Hsu YM, Liao CH, Wei YH, et al. Daptomycin-loaded polymethylmethacrylate bone cement for joint arthroplasty surgery. Artif Organs 2014; 38: 484-92. [Crossref]

9. Athans V, Veve MP, Davis SL. Trowels and tribulations: Review of antimicrobial-impregnated bone cements in prosthetic joint surgery. Pharmacotherapy 2017; 37: 1565-77. [Crossref]

10. Kaplan L, Kurdziel M, Baker KC, Verner J. Characterization of daptomycin-loaded antibiotic cement. Orthopedics 2012; 35: e503-9. [Crossref]

11. Rice DA, Mendez-Vigo L. Daptomycin in bone and joint infections: A review of the literature. Arch Orthop Trauma Surg 2009; 129: 1495-504. [Crossref]

12. Rodvold KA, Gotfried MH, Cwik M, Korth-Bradley JM, Dukart G, Ellis-Grosse EJ. Serum, tissue and body fluid concentrations of tigecycline after a single 100 mg dose. J Antimicrob Chemother 2006; 58: 1221-9. [Crossref]

13. Verkade EJ, Verhulst CJ, Huijsdens XW, Kluytmans JA. In vitro activity of tigecycline against methicillin-resistant Staphylococcus aureus, including livestock-associated strains. Eur J Clin Microbiol Infect Dis 2010; 29: 503-7. [Crossref]

14. Aslam S. Effect of antibacterials on biofilms. Am J Infect Control. 2008; 36: S175. e9-11. [Crossref]

15. Persson C, Baleani M, Guandalini L, Tigani D, Viceconti M. Mechanical effects of the use of vancomycin and meropenem in acrylic bone cement. Acta Orthop 2006; 77: 617-21. [Crossref]

16. Lee SH, Tai CL, Chen SY, Chang CH, Chang YH, Hsieh PH. Elution and mechanical strength of vancomycin-loaded bone cement: In vitro study of the influence of brand combination. PLoS One 2016; 11: e0166545. doi: 10.1371/journal.pone.0166545. [Crossref]

17. Paz E, Sanz-Ruiz P, Abenojar J, Vaquero-Martín J, Forriol F, Carlos del Real J. Evaluation of elution and mechanical properties of high-dose antibiotic-loaded bone cement: Comparative "In Vitro" study of the influence of vancomycin and cefazolin. J Arthroplasty 2015; 30: 1423-9. [Crossref]

18. Miller R, McLaren A, Leon C, McLemore R. Mixing method affects elution and strength of high-dose ALBC: A pilot study. Clin Orthop Relat Res 2012; 470: 2677-83. [Crossref]

19. Klekamp J, Dawson JM, Haas DW, DeBoer D, Christie M. The use of vancomycin and tobramycin in acrylic bone cement: Biomechanical effects and elution kinetics for use in joint arthroplasty. J Arthroplasty 1999; 14: 339-46. [Crossref]

20. Pelletier MH, Malisano L, Smitham PJ, Okamoto K, Walsh WR. The compressive properties of bone cements containing large doses of antibiotics. J Arthroplasty 2009; 24: 454-60. [Crossref]

21. Slane J, Gietman B, Squire M. Antibiotic elution from acrylic bone cement loaded with high doses of tobramycin and vancomycin. J Orthop Res 2018; 36: 1078-85. [Crossref]

22. Lewis G, Brooks JL, Courtney HS, Li Y, Haggard WO. An approach for determining antibiotic loading for a physician-directed antibiotic-loaded PMMA bone cement formulation. Clin Orthop Relat Res 2010; 468: 2092-100. [Crossref]

23. Ignjatović NL, Ninkov P, Sabetrasekh R, Lyngstadaas SP, Uskoković DP. In vitro evaluation of a multifunctional nano drug delivery system based on tigecycline-loaded calcium-phosphate/ poly-DL-lactide-co-glycolide. Biomed Mater Eng 2014; 24: 1647-58. [Crossref]

24. Kuehn KD, Ege W, Gopp U. Acrylic bone cements: mechanical and physical properties. Orthop Clin North Am 2005; 36: 29-39. [Crossref]

25. Harper EJ, Bonfield W. Tensile characteristics of ten commercial acrylic bone cements. J Biomed Mater Res 2000; 53: 605-16.

26. Chen G, Liu B, Liu H, et al. Calcium Phosphate Cement loaded with 10% vancomycin delivering high early and late local antibiotic concentration in vitro. Orthop Traumatol Surg Res 2018; 104: 1271-5. [Crossref]

27. Lee AJ, Ling RS, Gheduzzi S, Simon JP, Renfro RJ. Factors affecting the mechanical and viscoelastic properties of acrylic bone cement. J Mater Sci Mater Med 2002; 13: 723-33. [Crossref]