Development of Methodologies for Selection of Antibiotic-Loaded Acrylic Bone Cement (Gladius Lewis)

The prophylactic use of antibiotic-loaded poly (methyl methacrylate) bone cement (ALBC) is common in cemented total joint replacement (TJR) surgery as a means of reducing the potential for prosthetic joint infection following the procedure. Indeed, there is a plethora of commercially-available and approved ALBC brands, with each produced by using a proprietary method to blend the antibiotic into the cement powder.

One shortcoming of the literature on the properties of approved ALBC brands is that information on the basis for the selection of a given brand is lacking. The purpose of the project was to illustrate a rational method for making such a selection. To this end, four properties that have not been determined in previous studies (namely, fatigue limit, fracture toughness (FIGURES 1 and 2), polymerization rate, and coefficient of diffusion of phosphate buffered saline (which simulates body fluid)) of six approved brands were determined. The selection will be based on determination of rankings, accomplished by using the property values obtained, and a materials selection methodology, called the utility concept.

ALBC

FIGURE 1. Solid models of parts of  the mold used to fabricate fracture toughness test specimens used in the project:  bottom piece (A);  middle piece, shown in green color (B); pins, shown in green color (C); and top piece, shown in green color (D).  The fully assembled mold is also shown in (D).

  Dimensioned drawing of the fracture toughness test specimen, as fabricated using the mold shown in Figure 1.

FIGURE 2. Dimensioned drawing of the fracture toughness test specimen, as fabricated using the mold shown in Figure 1.


MS Student: Lohith Reddy Alluri Raja