Safety assessment of microsilver-loaded poly(methyl methacrylate) (PMMA) cement spacers in patients with prosthetic hip infections
| Autor: | Stephan Söder, Karsten Lemberger, Thomas Konradt, Thorsten Bechert, Reinhard Schnettler, Rudolf Ascherl, Peter Steinrücke, Markus Rupp, Volker Alt |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
030222 orthopedics
business.industry Hip infections Dentistry 02 engineering and technology 021001 nanoscience & nanotechnology Poly(methyl methacrylate) Preclinical data 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine chemistry visual_art Pmma cement visual_art.visual_art_medium Medicine Orthopedics and Sports Medicine Surgery In patient Methyl methacrylate 0210 nano-technology Prospective cohort study business Prosthetic infection |
| Zdroj: | Bone & Joint Research. 8:387-396 |
| ISSN: | 2046-3758 |
| DOI: | 10.1302/2046-3758.88.bjr-2018-0270.r1 |
| Popis: | Objectives Preclinical data showed poly(methyl methacrylate) (PMMA) loaded with microsilver to be effective against a variety of bacteria. The purpose of this study was to assess patient safety of PMMA spacers with microsilver in prosthetic hip infections in a prospective cohort study. Methods A total of 12 patients with prosthetic hip infections were included for a three-stage revision procedure. All patients received either a gentamicin-PMMA spacer (80 g to 160 g PMMA depending on hip joint dimension) with additional loading of 1% (w/w) of microsilver (0.8 g to 1.6 g per spacer) at surgery 1 followed by a gentamicin-PMMA spacer without microsilver at surgery 2 or vice versa. Implantation of the revision prosthesis was carried out at surgery 3. Results In total, 11 of the 12 patients completed the study. No argyria or considerable differences in laboratory parameters were detected. Silver blood concentrations were below or around the detection limit of 1 ppb in ten of the 11 patients. A maximum of 5.6 ppb at 48 hours after implantation of the silver spacer, which is below the recommended maximum level of 10 ppb, was found in one patient. No silver was detected in the urine. Drainage fluids showed concentrations between 16.1 ppb and 23.3 ppb at 12 hours after implantation of the silver spacers, and between 16.8 ppb to 25.1 ppb at 48 hours after implantation. Pathohistological assessment of the periprosthetic membrane did not reveal any differences between the two groups. Conclusion Microsilver-loaded gentamicin-PMMA spacers showed good biocompatibility and the broad antimicrobial activity warrants further clinical research to assess its effectivity in reducing infection rates in prosthetic joint infection. Cite this article: V. Alt, M. Rupp, K. Lemberger, T. Bechert, T. Konradt, P. Steinrücke, R. Schnettler, S. Söder, R. Ascherl. Safety assessment of microsilver-loaded poly(methyl methacrylate) (PMMA) cement spacers in patients with prosthetic hip infections: Results of a prospective cohort study. Bone Joint Res 2019;8:387–396. DOI: 10.1302/2046-3758.88.BJR-2018-0270.R1. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|