Enhanced antibiotic release of calcium sulfate bone cement using aqueous carboxymethyl cellulose gel

Periprosthetic infection is a serious complication of total joint arthroplasty, with high rates of associated morbidity. Existing prevention strategies include the use of antibiotic-loaded poly-(methyl methacrylate) (PMMA) cement spacers or beads to elevate local antibiotic levels at the surgical site, but this material has a number of significant disadvantages. It is a dense, acrylic, and non-resorbing material that release sub-inhibitory concentrations of drugs over an extended implantation period. Fully bio-absorbable carriers are now the subject of extensive investigation. Absorbable mineral-based bone cements are not as mechanically strong as acrylic cements, but they provide some advantages for antibiotic delivery and infection control.One such material is calcium sulfate. In this work, we have fabricated porous calcium sulfate bone cement with an aqueous biodegradable carboxymethyl cellulose gel, in the concentration of 0.5, 1, 1.5 and 2% (w/v), which is dispersed to create pores in the cement when cured. The fabricated bone cement was combined with gentamicin andimmersed in sterile phosphate-buffered saline at 37°C. Eluates were removed for analysis by UV-Vis spectrometry, within a certain time period. The results showed that optimum concentration of carboxymethyl cellulose gel for maxinmum release was 1.5%. In the first 9 days, gentamycin release were obtained up to 31%, which shows great drug release compared to PMMAbone cement.

Keywords:

Antibiotic , Bone cement , Calcium sulfate , Carboxymethyl cellulose , Drug release , Gentamycin