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

Orfanos, Georgios; Zderic, Ivan; Gueorguiev, Boyko; Nylund, Pamela; D'Este, Matteo; Varga, Peter; Okoro, Tosan

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.

Citation

Orfanos, G., Zderic, I., Gueorguiev, B., Nylund, P., D'Este, M., Varga, P., & Okoro, T. (2024). The impact of adjuvant antibiotic hydrogel application on the primary stability of uncemented hip stems. BMJ Surgery, Interventions, & Health Technologies, 6(1), https://doi.org/10.1136/bmjsit-2024-000307

• Journal Article Type: Article
• Acceptance Date: Oct 1, 2024
• Online Publication Date: Oct 18, 2024
• Publication Date: Oct 18, 2024
• Deposit Date: Nov 11, 2024
• Publicly Available Date: Nov 11, 2024
• Journal: BMJ Surgery, Interventions, & Health Technologies
• Electronic ISSN: 2631-4940
• Peer Reviewed: Peer Reviewed
• Volume: 6
• Issue: 1
• DOI: https://doi.org/10.1136/bmjsit-2024-000307
• Keywords: Prostheses and Implants
• Public URL: https://keele-repository.worktribe.com/output/974313
• Publisher URL: https://sit.bmj.com/content/6/1/e000307