The impact of adjuvant antibiotic hydrogel application on the primary stability of uncemented hip stems.

IF 2.1 Q2 SURGERY BMJ Surgery Interventions Health Technologies Pub Date : 2024-10-18 eCollection Date: 2024-01-01 DOI:10.1136/bmjsit-2024-000307
Georgios Orfanos, Ivan Zderic, Boyko Gueorguiev, Pamela Nylund, Matteo D'Este, Peter Varga, Tosan Okoro
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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.

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应用辅助抗生素水凝胶对非骨接合髋关节柄主要稳定性的影响。
目的评估应用抗生素水凝胶辅助剂对植入式非骨水泥髋关节柄主要稳定性的影响:设计:生物力学研究:使用装有 10 千牛称重传感器的电子机械材料测试系统(5866 号,Instron,Norwood,MA,USA)。采用阶梯加载协议,以 0.005 毫米/秒的速度进行准静态斜坡压缩加载,并以 500 牛顿的间歇加载步长在 500 牛顿到 3000 牛顿之间施加六个不同的加载水平:准备了12个人工股骨,并接受了无领非骨水泥标准偏置柄(Corail;DePuy Synthes,瑞士Zuchwil):干预措施:两组分别使用或不使用抗生素水凝胶:根据记录的载荷-位移曲线确定结构刚度,通过运动跟踪测量骨干下沉:结果:结构刚度(对照组:4176±240 N/mm;干预组:4588±448 N/mm)在组间无显著差异(p=0.076)。在各组中,随着负荷水平的增加,茎杆下沉明显增加(p≤0.002),但组间仍无明显差异(p=0.609):结论:在初级非骨水泥髋关节干稳定性方面,应用抗生素水凝胶的效果并不差。这一发现使得应用抗生素水凝胶辅助治疗具有潜在的可行性,但在应用于临床实践之前还需要进一步的研究。
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来源期刊
CiteScore
2.80
自引率
0.00%
发文量
22
审稿时长
17 weeks
期刊最新文献
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