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-morbidities together with the increasing spread of resistant pathogens, prevention is gaining increasing importance. Peri-operative antibiotic prophylaxis during implant surgery is a recognized necessity. Further addition of local antibiotics eluting from bone cement
Department of Orthopaedic Surgery, Vejle Hospital, Vejle, Denmark
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Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Lund University, Skåne University Hospital, Department of Orthopedics, Malmö, Sweden
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
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Department of Surgery, Epworth HealthCare, University of Melbourne, Melbourne, Australia
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Centre for Hip Surgery, Wrightington Hospital, Wrightington, Wigan and Leigh NHS Trust, Lancashire, United Kingdom
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Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark
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polyethylene liner. 25 , 26 Several bone cements were also identified as poorly performing after only three years of follow-up, especially the Boneloc cement and a low viscosity cement. 27 , 28 With a longer follow-up, three cemented implants
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Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
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Dept. of Orthopaedics, Radboud University Medical Center, Nijmegen, The Netherlands
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Dept. of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands
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components) ( Table 1 ). For bone cement, the name of bone cement, the manufacturer, type of cement, viscosity, whether the cement contains any antibiotics and use of a vacuum cement mixing system are collected ( Table 2 ). In 2014, the process described
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the 1970s, when gentamicin-loaded bone cement was first tested in humans. 57 Bone cement was a convenient vehicle for antibiotic delivery, as it was routinely applied in cemented arthroplasties. Gentamicin was identified as a suitable antibiotic
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delivering antibiotics by a local drug-delivery system was first followed by Buchholz et al, who mixed antibiotics and PMMA to create a local carrier. 25 From these findings, Klemm et al have developed techniques using antibiotic-loaded bone cement in
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failed systemically during their clinical use. These failures included corrosion-induced loosening of cemented titanium stems ( 4 ), mechanical breakdown of a polymethylmethacrylat (PMMA) bone cement due to problems with the glass transition temperature
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Mimetis Biomaterials, Spain
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porous network of micrometric/nanometric CaP crystals ( Fig. 2 ). 27 Unlike in acrylic bone cements, widely used in orthopaedic surgery for arthroplasty fixation and vertebroplasty, the setting reaction in CPC is not exothermic, 28 and therefore
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relates to high rates of contamination. In acute post-operative infections, sonicating parts of the implants that are covered with antibiotic-loaded bone cement may inhibit bacterial growth and lead to false negative results caused by increased antibiotic
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functionally equivalent to glenoid retroversion. Clinically, this is of relevance as significantly increased stress within the cement mantle and the glenoid bone as well as increased micromotion at the bone-cement interface has been associated with glenoid
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polymethylmethacrylate bone cements and Staphylococcus aureus biofilm formation . Acta Orthop Scand 2000 ; 71 : 625 – 629 . 23. Zimmerli W Widmer AF Blatter M Frei R Ochsner PE ; Foreign-Body Infection (FBI) Study