Enhancing PMMA Cements With Manually Added Antimicrobial Agents

Martina Humez; Mustafa Citak; Stefan Luck; Philip Linke; Thorsten Gehrke; Christian Paul; Klaus‐Dieter Kühn

doi:10.1111/apm.70029

journal article Open Access May 01, 2025

Enhancing PMMA Cements With Manually Added Antimicrobial Agents

Martina Humez

Mustafa Citak Stefan Luck Philip Linke

Thorsten Gehrke Christian Paul Klaus‐Dieter Kühn

APMIS Vol. 133 No. 5 · Wiley

View at Publisher Save 10.1111/apm.70029

Abstract

ABSTRACTPeriprosthetic joint infection (PJI) is an infrequent yet severe complication. A fundamental aspect of PJI treatment involves the use of polymethylmethacrylate (PMMA) cement augmented with antibiotics. For therapeutic application, it is often necessary to manually mix antibiotics with commercially produced PMMA cements. However, the potential issues arising from this manual admixing have not been thoroughly documented. This study aims to elucidate the impact of additional homogenization through dry mixing of a polymer‐active substance blend on the quality of manually mixed PMMA cement. In this laboratory‐based investigation, four cement samples were prepared using various methods for the manual incorporation and homogenization of the antibiotic vancomycin. The reference controls were Copal G + V and Copal G + C pro (Heraeus Medical GmbH, Wehrheim, Germany), representing commercially available PMMA cements and a closed mixing system. The samples were analyzed for mechanical, microbiological, and microscopic properties. The mechanical and microbiological analyses revealed no statistically significant differences between the manually mixed samples and the references. However, microscopic examination of the mixing cartridges' inner surfaces indicated scratching and signs of abrasion during the mixing process. The manual incorporation of antibiotics into PMMA cement should be limited to specific indications, with a preference for using commercially available mixtures whenever possible.

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Details

Published: May 01, 2025
Vol/Issue: 133(5)
License: View

Authors

M

Martina Humez

Institute of Microbiology and Molecular Biology Justus‐Liebig‐Universität Giessen Giessen Germany

M

Mustafa Citak

Department of Orthopedic Surgery Helios ENDO‐Klinik Hamburg Germany

S

Stefan Luck

Department of Orthopedic Surgery Helios ENDO‐Klinik Hamburg Germany

P

Philip Linke

Department of Orthopedic Surgery Helios ENDO‐Klinik Hamburg Germany

T

Thorsten Gehrke

Department of Orthopedic Surgery Helios ENDO‐Klinik Hamburg Germany

C

Christian Paul

Institute of Physical Chemistry Justus‐Liebig‐University Giessen Germany

K

Klaus‐Dieter Kühn

Department of Orthopaedics and Trauma Medical University of Graz Graz Austria

Cite This Article

Martina Humez, Mustafa Citak, Stefan Luck, et al. (2025). Enhancing PMMA Cements With Manually Added Antimicrobial Agents. APMIS, 133(5). https://doi.org/10.1111/apm.70029

Enhancing PMMA Cements With Manually Added Antimicrobial Agents

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