Antibiotic-Loaded Bone Allograft: Personal Experience

Original article


Abdulrazag Shakshukhi 1, Giovanni Gualdrini 1, Luca Amendola 2, Rida Ben Ayad 2, Armando Giunti 2

1) Department of Orthopaedics, Central Hospital, Tripoli, Libya; 2) 7th Division of Orthopaedics and Traumatology, Rizzoli Orthopedic Institute, Bologna, Italy

JMJ Vol.7, No.3 (Autumn 2007):206-210


The main purposes are to present the objective principle of this work which emphasized the antibiotic loaded bone allograft experience and the results of a research on the characteristics “in vitro” and “in vivo” of this material (morcellized antibiotic loaded bone allograft with PMMA) related to our orthopaedic field. Since 1998 in the Rizzoli Institute morcellized bone graft has been used for the treatment of bone loss caused by different pathologies. Material and methods: since 1998 to 2002, in Rizzoli Institute 249 patients have been operated for different orthopaedic pathological reasons, in most of the cases treated to restore the septic bone defect, a large quantity of morcellized antibiotic loaded bone allograft was used. The good outcome from the use of the morcellized-defatted and antibiotic loaded allograft invited our mind to a research about physical and clinical characteristic of a new composite (which we called CAMB): morcellized allograft with vancomycin impregnated in PMMA, in order to search for a bio-artificial substance similar to human bone. The outcome of morcellized bone allograft with vancomycin and PMMA (CAMB) “in vitro” and in human plasma was best antibiotic carrier compared to PMMA impregnated in antibiotic only, both in human plasma and saline solution. The mechanical characterization of the composite CAMB established a compressive strength of 13,6 mega-Pascal, comparable to the compressive strength measured for human cancellous bone. Since these peculiarities, we have considered useful to verify the biocompatibility in vivo of the CAMB. Conclusion: morcellized bone graft has a high resistance to septic breakdown, but low resistance to mechanical strength. It has a good affinity to antibiotic release and a good bone-induction. About its carrier properties, we think that it is necessary to have much more experience to evaluate its efficiency. About CAMB composite we can emphasize it for the best antibiotic delivery in human plasma, for the high resistance to mechanical loading and a good “in vivo” biocompatibility.

Keywords: Bone allograft, Antibiotic loaded, Poly Methyl Metha crylate acid, Biocompatibility