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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 5,
643-647.
doi: 10.1302/0301-620X.90B5.19803 Copyright © 2008 by British Editorial Society of Bone and Joint Surgery Orthopaedic bone cementDO WE KNOW WHAT WE ARE USING?J. Bridgens, FRCS(Tr & Orth), Orthopaedic Specialist Registrar1; S. Davies, FIBMS, Medical Microbiologist1; L. Tilley, FIBMS, Medical Microbiologist1; P. Norman, FRCPath, Consultant Medical Microbiologist1; and I. Stockley, FRCS, Consultant Orthopaedic Surgeon11 Northern General Hospital, Herries Road, Sheffield S5 7AU, UK. Correspondence should be sent to Mr J. Bridgens; e-mail: jpbridgens{at}doctors.org.uk
Bone cements produced by different manufacturers vary in their mechanical properties and antibiotic elution characteristics. Small changes in the formulation of a bone cement, which may not be apparent to surgeons, can also affect these properties. The supplier of Palacos bone cement with added gentamicin changed in 2005. We carried out a study to examine the mechanical characteristics and antibiotic elution of Schering-Plough Palacos, Heraeus Palacos and Depuy CMW Smartset bone cements. Both Heraeus Palacos and Smartset bone cements performed significantly better than Schering-Plough Palacos in terms of mechanical characteristics, with and without additional vancomycin (p < 0.001). All cements show a deterioration in flexural strength with increasing addition of vancomycin, albeit staying above ISO minimum levels. Both Heraeus Palacos and Smartset elute significantly more gentamicin cumulatively than Schering-Plough Palacos. Smartset elutes significantly more vancomycin cumulatively than Heraeus Palacos. The improved antibiotic elution characteristics of Smartset and Heraeus Palacos are not associated with a deterioration in mechanical properties. Although marketed as the original Palacos, Heraeus Palacos has significantly altered mechanical and antibiotic elution characteristics compared with the most commonly-used previous version.
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