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Vancomycin Elution Kinetics from Porous Tantalum Metal

Abstract : Revisions TKAs are being completed with uncemented constructs more frequently. We hypothesized that tantalum cones could be an efficient carrier of antibiotics in uncemented procedures. We aimed to compare the release of vancomycin between (i) tantalum and smooth stainless cylinders; (ii) different concentrations of vancomycin; and (iii) different durations of bathing. Specifically designed tantalum cylinders were bathed in a vancomycin solution with various durations of baths. We investigated rinses between each interval as well as the dose of vancomycin. Vancomycin concentrations were determined in each group by fluorescence polarization immunoassay at different intervals (1 h, days 1, 2, 3, 5). At 1 h, the mean vancomycin concentration for the 1‐hour soaking group was 3,172 μg/ml, whereas mean concentration for the smooth stainless steel group was 39.37 μg/ml (p < 0.001). The rinsing group showed a significantly lower concentration at 1 h and 1 day (p < 0.05). The 2‐gram vancomycin group showed no difference at days 1, 2, and 3 compared to the 1‐hour group. The 5, 15, and 30‐minute bathing groups showed significantly lower vancomycin concentrations at all‐time points. All vancomycin concentrations at day 3 were superior to the minimal inhibitory concentration of Staphyloccocus aureus. The mean concentration of vancomycin depends on the material, duration of bathing, the rinsing effect, and the drug dose. Our in‐vitro study is the first to show that porous tantalum cylinders allow antibiotic carriage and progressive release. If appearing in vivo, in a similar extent, this intrinsic property might be useful to prevent and/or treat peri‐prosthetic joint infection.
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Pierre Sautet, Thibaut Mékidèche, Romain Guilhaumou, Matthew Abdel, Jean-Noël Argenson, et al.. Vancomycin Elution Kinetics from Porous Tantalum Metal. Journal of Orthopaedic Research, Wiley, 2019, 37 (2), pp.308-312. ⟨10.1002/jor.24160⟩. ⟨hal-02528762⟩



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