Georgios Orfanos, Ivan Zderic, Boyko Gueorguiev, Pamela Nylund, Matteo D'Este, Peter Varga, Tosan Okoro
{"title":"The impact of adjuvant antibiotic hydrogel application on the primary stability of uncemented hip stems.","authors":"Georgios Orfanos, Ivan Zderic, Boyko Gueorguiev, Pamela Nylund, Matteo D'Este, Peter Varga, Tosan Okoro","doi":"10.1136/bmjsit-2024-000307","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effect of adjuvant antibiotic-loaded hydrogel application on the primary stability of implanted uncemented hip stems.</p><p><strong>Design: </strong>Biomechanical study.</p><p><strong>Setting: </strong>An electro-mechanic material test system (#5866, Instron, Norwood, MA, USA) equipped with a 10-kN load cell was used. A staircase loading protocol was applied via quasi-static ramped compression loading at 0.005 mm/s and six different load levels between 500 N and 3000 N in 500 N intermittent load increase steps.</p><p><strong>Participants: </strong>12 artificial femora were prepared and received a collarless uncemented standard offset stem (Corail; DePuy Synthes, Zuchwil, Switzerland).</p><p><strong>Interventions: </strong>The two groups were prepared with or without the antibiotic-loaded hydrogel.</p><p><strong>Main outcome measures: </strong>Construct stiffness was determined from the recorded load-displacement curves and stem subsidence was measured via motion tracking.</p><p><strong>Results: </strong>Construct stiffness (control: 4176±240 N/mm; intervention: 4588±448 N/mm) was not significantly different between the groups (p=0.076). Stem subsidence increased significantly over the increasing load levels in each separate group (p≤0.002) and remained not significantly different between the groups (p=0.609).</p><p><strong>Conclusions: </strong>The application of antibiotic-loaded hydrogel was associated with non-inferior performance in terms of primary uncemented hip stem stability. This finding makes the prospect of adjuvant antibiotic-loaded hydrogel application potentially feasible; however, it requires further investigations prior to translation in the clinical practice.</p>","PeriodicalId":33349,"journal":{"name":"BMJ Surgery Interventions Health Technologies","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492958/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Surgery Interventions Health Technologies","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjsit-2024-000307","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: To assess the effect of adjuvant antibiotic-loaded hydrogel application on the primary stability of implanted uncemented hip stems.
Design: Biomechanical study.
Setting: An electro-mechanic material test system (#5866, Instron, Norwood, MA, USA) equipped with a 10-kN load cell was used. A staircase loading protocol was applied via quasi-static ramped compression loading at 0.005 mm/s and six different load levels between 500 N and 3000 N in 500 N intermittent load increase steps.
Participants: 12 artificial femora were prepared and received a collarless uncemented standard offset stem (Corail; DePuy Synthes, Zuchwil, Switzerland).
Interventions: The two groups were prepared with or without the antibiotic-loaded hydrogel.
Main outcome measures: Construct stiffness was determined from the recorded load-displacement curves and stem subsidence was measured via motion tracking.
Results: Construct stiffness (control: 4176±240 N/mm; intervention: 4588±448 N/mm) was not significantly different between the groups (p=0.076). Stem subsidence increased significantly over the increasing load levels in each separate group (p≤0.002) and remained not significantly different between the groups (p=0.609).
Conclusions: The application of antibiotic-loaded hydrogel was associated with non-inferior performance in terms of primary uncemented hip stem stability. This finding makes the prospect of adjuvant antibiotic-loaded hydrogel application potentially feasible; however, it requires further investigations prior to translation in the clinical practice.