PMID- 36597743
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231025
IS  - 1554-527X (Electronic)
IS  - 0736-0266 (Linking)
VI  - 41
IP  - 8
DP  - 2023 Aug
TI  - Antibiotic release from PMMA spacers and PMMA beads measured with ELISA: 
      Assessment of in vitro samples and drain fluid samples of patients.
PG  - 1831-1839
LID - 10.1002/jor.25510 [doi]
AB  - For prosthetic joint infections, antibiotic loaded poly methyl methacrylate 
      (PMMA) spacer or beads can be used to release high concentrations of antibiotics 
      locally at the infection site, while minimizing systemic toxicity. The aim of 
      this study is to determine in vitro and in vivo pharmacokinetic release profile 
      of antibiotics from PMMA spacers and PMMA beads. For the in vitro experiment, the 
      PMMA spacers or beads were submerged in phosphate-buffered saline and gentamicin 
      concentrations were determined from collected specimen at several times points, 
      measured with enzyme-linked immunosorbent assays (ELISA). To assess the in vivo 
      antibiotic release profile of different spacers, wound drainage fluid samples 
      were collected after implantation of a spacer over a period of maximum 14 
      days. After 48 h, the burst gentamicin concentration elution was 
      9862 +/- 1782 ng/ml (mean +/- SD) from spacers versus 38,394 +/- 7071 ng/ml (mean +/- SD) 
      for beads. Over 35 days, spacers had eluted a cumulative mean concentration of 
      13,812 +/- 3548 versus 55,048 +/- 12,006 ng/ml for beads (p < 0.001). Clinical 
      samples of patients with a Vancogenx(R) spacer showed higher gentamicin release 
      than Refobacin spacers (p < 0.001). This is the first study that measured the 
      release data of local antibiotics with ELISA. Compare to spacers, the exact 
      release values of gentamicin from PMMA beads are more than 10 times higher and 
      reached a maximum much later than spacers. This makes the use of PMMA beads more 
      preferable to use for treatment of the infection itself.
CI  - (c) 2023 Orthopaedic Research Society.
FAU - Janssen, Daniel M C
AU  - Janssen DMC
AUID- ORCID: 0000-0001-7847-1855
AD  - Department of Orthopaedic Surgery, Laboratory for Experimental Orthopaedics, 
      Research School CAPHRI, Maastricht University Medical Centre+, Maastricht, The 
      Netherlands.
AD  - Sint-Trudo Hospital, Sint-Truiden, Belgium.
FAU - Willems, Paul
AU  - Willems P
AD  - Department of Orthopaedic Surgery, Laboratory for Experimental Orthopaedics, 
      Research School CAPHRI, Maastricht University Medical Centre+, Maastricht, The 
      Netherlands.
FAU - Geurts, Jan
AU  - Geurts J
AUID- ORCID: 0000-0002-0973-572X
AD  - Department of Orthopaedic Surgery, Laboratory for Experimental Orthopaedics, 
      Research School CAPHRI, Maastricht University Medical Centre+, Maastricht, The 
      Netherlands.
FAU - Arts, Chris J J
AU  - Arts CJJ
AUID- ORCID: 0000-0002-2947-8564
AD  - Department of Orthopaedic Surgery, Laboratory for Experimental Orthopaedics, 
      Research School CAPHRI, Maastricht University Medical Centre+, Maastricht, The 
      Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20230119
PL  - United States
TA  - J Orthop Res
JT  - Journal of orthopaedic research : official publication of the Orthopaedic 
      Research Society
JID - 8404726
RN  - 0 (Anti-Bacterial Agents)
RN  - 9011-14-7 (Polymethyl Methacrylate)
RN  - 0 (Bone Cements)
RN  - 0 (Gentamicins)
SB  - IM
MH  - Humans
MH  - *Anti-Bacterial Agents/therapeutic use
MH  - Polymethyl Methacrylate
MH  - Bone Cements
MH  - Gentamicins/pharmacokinetics
MH  - Drainage
MH  - Enzyme-Linked Immunosorbent Assay
MH  - *Prosthesis-Related Infections/drug therapy
OTO - NOTNLM
OT  - ELISA
OT  - gentabeads
OT  - pharmacokinetic release profile
OT  - poly methyl methacrylate (PMMA)
OT  - spacers
EDAT- 2023/01/05 06:00
MHDA- 2023/10/23 12:43
CRDT- 2023/01/04 03:42
PHST- 2022/11/30 00:00 [revised]
PHST- 2022/08/22 00:00 [received]
PHST- 2022/12/21 00:00 [accepted]
PHST- 2023/10/23 12:43 [medline]
PHST- 2023/01/05 06:00 [pubmed]
PHST- 2023/01/04 03:42 [entrez]
AID - 10.1002/jor.25510 [doi]
PST - ppublish
SO  - J Orthop Res. 2023 Aug;41(8):1831-1839. doi: 10.1002/jor.25510. Epub 2023 Jan 19.