Role of antibiotic loaded acrylic bone cement in orthopedic infection

Abstract

Introduction: Local antibiotic delivery with antibiotic loaded acrylic bone cement has been used extensively in the management of chronic osteomyelitis and implant related infections. It is considered the gold standard for treatment of musculoskeletal infections (Nelson, 2004). Over the past few decades, attempts have been made to prevent and cure orthopedic implant infections by incorporating antibiotics in polymethylmethacrylate bone cements, in primary and revision surgery. Antibiotic loaded bone cement (ALBC) is popular as it is a proven way to deliver high concentrations of the drug locally, even to avascular areas that are inaccessible by systemic antibiotics. This article review the role of antibiotic loaded acrylic bone cement beads in orthopaedic trauma. Materials & Methods: This is a Prospective, Non Randomized study carried out in 40 patients posted for orthopaedic procedures. For evaluating the functional outcome of treatment we used the Asepsis Wound Score. Total duration of study is 6 to 9 months. Results: The mean age of the patient was 40 years (range 20-50 yrs). Incidence of fracture was observed maximum between 40- 50 years of age. Among the 40 cases, males were predominant. We observed predominance Staphylococcus Organism in Pus Culture. Out of 40 cases 53% cases was open fractures and 70% cases were RTA. Conclusion: The theoretical advantages of antibiotic-impregnated cement and cement beads in the treatment and prophylaxis of orthopedic infections are supported by the results of some studies but Evidence of their efficacy, particularly in comparison with those of systemic antibiotics or with those of antibiotic-impregnated cement or beads in combination with systemic antibiotics, have not been firmly established. In our study there was marked decrease in infection rate by using antibiotic cemented beads but certain infection like Chronic osteomyelitis is often a lifelong disease. Despite all of the advances in antibiotic and operative treatment, osteomyelitis remains difficult to treat.