The effect of N-acetylcysteine on mechanical fatigue resistance of antibiotic-loaded bone cement.

Autor: Sukur, Erhan, Akar, Abdulhalim, Topcu, Huseyin Nevzat, Cicekli, Ozgur, Kochai, Alauddin, Turker, Mehmet
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Zdroj: Journal of Orthopaedic Surgery & Research; 5/31/2018, Vol. 13 Issue 1, pN.PAG-N.PAG, 1p, 2 Color Photographs, 2 Charts, 1 Graph
Abstrakt: Background: This biomechanical study evaluates the effect of N-acetylcysteine alone and in combination with the most commonly used antibiotic-loaded bone cement mixtures. Methods: We mixed eight bone cement mixture groups including combinations of N-acetylcysteine, gentamicin, teicoplanin, and vancomycin and applied a four-point bending test individually to each sample on days 1 and 15 using an MTS Acumen test device. Results: The result was less than 50 MPa—the limit declared by the ISO (International Standards Organization)—in only the "gentamicin + bone cement + N-acetylcysteine" group. Mechanical fatigue resistance of the bone cement decreased significantly with the addition of N-acetylcysteine both on day 1 and day 15 (p < 0.001). With the addition of N-acetylcysteine into the "gentamicin + bone cement" and "vancomycin + bone cement" mixtures, a significant decrease in mechanical fatigue resistance was observed both on day 1 and day 15 (p < 0.001). In contrast, with the addition of N-acetylcysteine into the "teicoplanin + bone cement" mixture, no significant difference in mechanical fatigue resistance was observed on days 1 and 15 (p = 0.093, p = 0.356). Conclusion: Preliminary results indicate that adding N-acetylcysteine to teicoplanin-loaded bone cement does not significantly affect the cement's mechanical resistance, potentially leading to a new avenue for preventing and treating peri-prosthetic joint infection. N-acetylcysteine may, therefore, be considered as an alternative agent to be added to antibiotic-loaded bone cement mixtures used in the prevention of peri-prosthetic joint infection. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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