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I Stockley - One of the best experts on this subject based on the ideXlab platform.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Orthopaedic Proceedings, 2018Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:IntroductionVancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement.MethodsA total of 18 cement discs of constant size, containing either proprietary CopalG+V®; or ‘home-made’ CopalR+G® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester.Results...
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comparison of the elution properties of commercially available gentamicin and bone cement containing vancomycin with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: N Frew, T Cannon, Tim Nichol, Thomas J Smith, I StockleyAbstract:Aims Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from ‘home-made’ cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. Materials and Methods A total of 18 cement discs containing either proprietary CopalG+V; or ‘home-made’ CopalR+G with vancomycin added by hand, were made. Each disc contained the same amount of antibiotic (0.5 g Gentamycin, 2 g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two-week period. The concentrations of gentamicin and vancomycin in the fluid were analysed using high performance liquid chromatography mass spectrometry. Results The highest peak concentrations of antibiotic were observed from the ‘home-made’ cements containing vancomycin, added as in the operating theatre. The overall elution of antibiotic was, fivefold (vancomycin) and twofold (gentamicin) greater from the ‘home-made’ mix compared with the commercially mixed cement. The use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Conclusion These findings suggest that the addition of 2 g vancomycin powder to gentamicin-impregnated bone cement by hand significantly increases the elution of both antibiotics compared with commercially prepared cements containing vancomycin. We found no significant advantages of using expensive commercially produced vancomycin-impregnated cement and recommend the addition of vancomycin powder by hand in the operating theatre. Cite this article: Bone Joint J 2017;99-B:73–7.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:Introduction Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement. Methods A total of 18 cement discs of constant size, containing either proprietary CopalG+V ® ; or ‘home-made’ CopalR+G ® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester. Results Highest peak antibiotic concentrations were observed from the ‘home-made’ vancomycin containing cement, added as in the operating theatre. Overall antibiotic elution was, five-fold (vancomycin) and two-fold (gentamicin), greater from the ‘home-made’ mix compared to commercially mixed cement. However the ‘home-made’ cements showed greater variation in elution kinetics compared to the commercial mix. Use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Impact strength testing showed no significant differences between the groups. Discussion Our findings suggest the addition of 2g vancomycin powder to gentamicin-impregnated bone cement in theatre, significantly increases elution of both antibiotics, with no significant loss of strength, compared to commercially prepared cement. Conclusion We have found no significant advantages of expensive off-the-shelf vancomycin-impregnated bone cement and recommend the addition of vancomycin powder by hand when making cement beads and spacers.
N Frew - One of the best experts on this subject based on the ideXlab platform.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Orthopaedic Proceedings, 2018Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:IntroductionVancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement.MethodsA total of 18 cement discs of constant size, containing either proprietary CopalG+V®; or ‘home-made’ CopalR+G® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester.Results...
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comparison of the elution properties of commercially available gentamicin and bone cement containing vancomycin with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: N Frew, T Cannon, Tim Nichol, Thomas J Smith, I StockleyAbstract:Aims Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from ‘home-made’ cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. Materials and Methods A total of 18 cement discs containing either proprietary CopalG+V; or ‘home-made’ CopalR+G with vancomycin added by hand, were made. Each disc contained the same amount of antibiotic (0.5 g Gentamycin, 2 g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two-week period. The concentrations of gentamicin and vancomycin in the fluid were analysed using high performance liquid chromatography mass spectrometry. Results The highest peak concentrations of antibiotic were observed from the ‘home-made’ cements containing vancomycin, added as in the operating theatre. The overall elution of antibiotic was, fivefold (vancomycin) and twofold (gentamicin) greater from the ‘home-made’ mix compared with the commercially mixed cement. The use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Conclusion These findings suggest that the addition of 2 g vancomycin powder to gentamicin-impregnated bone cement by hand significantly increases the elution of both antibiotics compared with commercially prepared cements containing vancomycin. We found no significant advantages of using expensive commercially produced vancomycin-impregnated cement and recommend the addition of vancomycin powder by hand in the operating theatre. Cite this article: Bone Joint J 2017;99-B:73–7.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:Introduction Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement. Methods A total of 18 cement discs of constant size, containing either proprietary CopalG+V ® ; or ‘home-made’ CopalR+G ® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester. Results Highest peak antibiotic concentrations were observed from the ‘home-made’ vancomycin containing cement, added as in the operating theatre. Overall antibiotic elution was, five-fold (vancomycin) and two-fold (gentamicin), greater from the ‘home-made’ mix compared to commercially mixed cement. However the ‘home-made’ cements showed greater variation in elution kinetics compared to the commercial mix. Use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Impact strength testing showed no significant differences between the groups. Discussion Our findings suggest the addition of 2g vancomycin powder to gentamicin-impregnated bone cement in theatre, significantly increases elution of both antibiotics, with no significant loss of strength, compared to commercially prepared cement. Conclusion We have found no significant advantages of expensive off-the-shelf vancomycin-impregnated bone cement and recommend the addition of vancomycin powder by hand when making cement beads and spacers.
Harald Steen - One of the best experts on this subject based on the ideXlab platform.
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higher concentration of vancomycin and Gentamycin in joint fluid in theatre made hipspacers compared with commercially available ready made hipspacers
Orthopaedic Proceedings, 2018Co-Authors: J Slastad, Harald SteenAbstract:We wanted to study the risk of systemic toxic effect of Gentamycin/vancomycin loaded spacers, and to investigate whether there is any difference in the elution of Gentamycin and vancomycin to the j...
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higher concentration of vancomycin and Gentamycin in joint fluid in theatre made hipspacers compared with commercially available ready made hipspacers
Journal of Bone and Joint Surgery-british Volume, 2015Co-Authors: J Slastad, Harald SteenAbstract:We wanted to study the risk of systemic toxic effect of Gentamycin/vancomycin loaded spacers, and to investigate whether there is any difference in the elution of Gentamycin and vancomycin to the joint fluid between theatre- made and in factory ready-made spacers The study consists of 28 patients. In group one, 14 patients were given a in factory ready-made spacer containing Gentamycin 1,1g – 3,2g and vancomycin 1,1g – 3,2g depending of the size of the spacer. In group two, 14 patients were given spacers made in the operating theatre. from PMMA containing 0,5 g Gentamycin in each 40 g batch. 4 g vancomycin were added to each batch of 40 g PMMA. The concentration of Gentamycin and vancomycin was measured from drainfluid and in serum day 1 and 2 after the operation Group one Group two Significance Vancomycin drain day 1 10,3 (2,0–23.3) 88,5 (11,7–242,9) p Vancomycin drain day 2 6,3 (2,0–17,5) 55,2 (7,5–161,0) p Vancomycin serum day 1 2,0 (2,0–2,0) 1,8 (0,7–2.0) ns Vancomycin serum day 2 2,0 (1,6–2,2) 1,9 (1,0–2,0) ns Gentamycin drain day 1 23,4 (0,5–68,0) 44,3 (11,0–117,5) p=0,05 Gentamycin drain day 2 8,7 (0,8–16,1) 18,0 (6,8–45,3) p Gentamycin serum day 1 0,2 (0,2–0,2) 0,3 (0,2–1,3) ns Gentamycin serum day 2 0,2 (0,0–0,2) 0,3 (0,2–1,1) ns In theatre-made spacers had a significant higher concentration of both Gentamycin and vancomycin in the joint fluid. Even with very high consentrations of Gentamycin and vancomycin in the joint fluid the concentrations in serum were far below the toxic limit and no toxic reactions were observed Gentamycin and vancomycin added to the hip spacers only to a very small degree passes to the circulation system. In theatre-made spacers have a significantly higher elution of Gentamycin and vancomycin than in factory ready-made spacers. If a high initial concentration of Gentamycin and vancomycin in joint fluid is desired. in theatre-made spacers should be considered.
Thomas J Smith - One of the best experts on this subject based on the ideXlab platform.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Orthopaedic Proceedings, 2018Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:IntroductionVancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement.MethodsA total of 18 cement discs of constant size, containing either proprietary CopalG+V®; or ‘home-made’ CopalR+G® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester.Results...
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comparison of the elution properties of commercially available gentamicin and bone cement containing vancomycin with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: N Frew, T Cannon, Tim Nichol, Thomas J Smith, I StockleyAbstract:Aims Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from ‘home-made’ cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. Materials and Methods A total of 18 cement discs containing either proprietary CopalG+V; or ‘home-made’ CopalR+G with vancomycin added by hand, were made. Each disc contained the same amount of antibiotic (0.5 g Gentamycin, 2 g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two-week period. The concentrations of gentamicin and vancomycin in the fluid were analysed using high performance liquid chromatography mass spectrometry. Results The highest peak concentrations of antibiotic were observed from the ‘home-made’ cements containing vancomycin, added as in the operating theatre. The overall elution of antibiotic was, fivefold (vancomycin) and twofold (gentamicin) greater from the ‘home-made’ mix compared with the commercially mixed cement. The use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Conclusion These findings suggest that the addition of 2 g vancomycin powder to gentamicin-impregnated bone cement by hand significantly increases the elution of both antibiotics compared with commercially prepared cements containing vancomycin. We found no significant advantages of using expensive commercially produced vancomycin-impregnated cement and recommend the addition of vancomycin powder by hand in the operating theatre. Cite this article: Bone Joint J 2017;99-B:73–7.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:Introduction Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement. Methods A total of 18 cement discs of constant size, containing either proprietary CopalG+V ® ; or ‘home-made’ CopalR+G ® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester. Results Highest peak antibiotic concentrations were observed from the ‘home-made’ vancomycin containing cement, added as in the operating theatre. Overall antibiotic elution was, five-fold (vancomycin) and two-fold (gentamicin), greater from the ‘home-made’ mix compared to commercially mixed cement. However the ‘home-made’ cements showed greater variation in elution kinetics compared to the commercial mix. Use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Impact strength testing showed no significant differences between the groups. Discussion Our findings suggest the addition of 2g vancomycin powder to gentamicin-impregnated bone cement in theatre, significantly increases elution of both antibiotics, with no significant loss of strength, compared to commercially prepared cement. Conclusion We have found no significant advantages of expensive off-the-shelf vancomycin-impregnated bone cement and recommend the addition of vancomycin powder by hand when making cement beads and spacers.
Tim Nichol - One of the best experts on this subject based on the ideXlab platform.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Orthopaedic Proceedings, 2018Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:IntroductionVancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement.MethodsA total of 18 cement discs of constant size, containing either proprietary CopalG+V®; or ‘home-made’ CopalR+G® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester.Results...
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comparison of the elution properties of commercially available gentamicin and bone cement containing vancomycin with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2017Co-Authors: N Frew, T Cannon, Tim Nichol, Thomas J Smith, I StockleyAbstract:Aims Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available, but are significantly more expensive. We investigated whether the elution of antibiotic from ‘home-made’ cement containing vancomycin was comparable with more expensive commercially available vancomycin impregnated cement. Materials and Methods A total of 18 cement discs containing either proprietary CopalG+V; or ‘home-made’ CopalR+G with vancomycin added by hand, were made. Each disc contained the same amount of antibiotic (0.5 g Gentamycin, 2 g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two-week period. The concentrations of gentamicin and vancomycin in the fluid were analysed using high performance liquid chromatography mass spectrometry. Results The highest peak concentrations of antibiotic were observed from the ‘home-made’ cements containing vancomycin, added as in the operating theatre. The overall elution of antibiotic was, fivefold (vancomycin) and twofold (gentamicin) greater from the ‘home-made’ mix compared with the commercially mixed cement. The use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Conclusion These findings suggest that the addition of 2 g vancomycin powder to gentamicin-impregnated bone cement by hand significantly increases the elution of both antibiotics compared with commercially prepared cements containing vancomycin. We found no significant advantages of using expensive commercially produced vancomycin-impregnated cement and recommend the addition of vancomycin powder by hand in the operating theatre. Cite this article: Bone Joint J 2017;99-B:73–7.
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comparison of the elution properties of commercially available gentamicin and vancomycin impregnated bone cement with home made preparations
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: N Frew, Tim Nichol, Thomas J Smith, I StockleyAbstract:Introduction Vancomycin is commonly added to acrylic bone cement during revision arthroplasty surgery. Proprietary cement preparations containing vancomycin are available but significantly more expensive. We investigated whether the antibiotic elution and mechanical strength of ‘home-made’ vancomycin containing bone cement was comparable to commercial vancomycin-impregnated cement. Methods A total of 18 cement discs of constant size, containing either proprietary CopalG+V ® ; or ‘home-made’ CopalR+G ® with vancomycin added by hand, were made. Each disc contained the same antibiotic quantities (0.5g Gentamycin, 2g vancomycin) and was immersed in ammonium acetate buffer in a sealed container. Fluid from each container was sampled at eight time points over a two week period. The concentration of gentamicin and vancomycin in the fluid was analysed using high performance liquid chromatography mass spectrometry. The impact strength of each PMMA cement preparation was measured using a Charpy-type impact tester. Results Highest peak antibiotic concentrations were observed from the ‘home-made’ vancomycin containing cement, added as in the operating theatre. Overall antibiotic elution was, five-fold (vancomycin) and two-fold (gentamicin), greater from the ‘home-made’ mix compared to commercially mixed cement. However the ‘home-made’ cements showed greater variation in elution kinetics compared to the commercial mix. Use of a vacuum during mixing had no significant effect on antibiotic elution in any of the samples. Impact strength testing showed no significant differences between the groups. Discussion Our findings suggest the addition of 2g vancomycin powder to gentamicin-impregnated bone cement in theatre, significantly increases elution of both antibiotics, with no significant loss of strength, compared to commercially prepared cement. Conclusion We have found no significant advantages of expensive off-the-shelf vancomycin-impregnated bone cement and recommend the addition of vancomycin powder by hand when making cement beads and spacers.