Abstract

BAGLIARDELLI, Julio et al. Value of using antibiotic-loaded cement spacers and allograft to reconstruct infected bone defects: experimental study in rabbits. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2011, vol.76, n.2, pp.133-140. ISSN 1852-7434.

Background: The purpose of this experimental study was to evaluate in rabbits different types of treatment in infected open fractures with bone loss. Methods: Twenty five adult rabbits were included in the study. A mid-diaphyseal open fracture of the femur was reproduced in all of them, and subsequently contaminated with Staphylococcus aureus. Group I was not treated (control group). In Group II, polymethylmethacrylate with gen-tamicin and vancomycin was placed in the fracture site, associated to systemic antibiotics. Group III was given polymethylmethacrylate without antibiotic in the fracture site, associated to systemic antibiotics. Group IV received fresh frozen morselized allograft with vancomycin in the fracture site, associated to systemic antibiotics. Group V only received systemic antibiotics. The pseudomembrane formed around the cement was histologically evaluated. Results: In Group I, five cultures were positive for Staphylococcus aureus. In Groups II and IV, all cultures were negative. In Group III, four cultures were negative and one was positive. In Group V, two were negative and three were positive. The histological results were similar in the groups in which cement had been used; this showed that the addition of antibiotics to the cement does not alter the histological characteristics of the pseudomembrane. Conclusions: For primary open fracture reconstruction, the addition of antibiotics to the bone graft helps prevent infection; and if staged reconstruction is prioritized, placing a polymethylmethacrylate spacer with antibiotics in the defect during the first stage should be considered.

Keywords : Polymethylmethacrylate; Rabbits; Antibiotic; Pseudomembrane.

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