Journal List > J Korean Orthop Assoc > v.46(4) > 1013079

Kwon, Chang, Lee, Lee, Lee, Hwang, Lee, and Byun: The Effect of Cefazolin on Mechanical Properties and Antibacterial Reactions of Calcium Phosphate Cement

Abstract

Purpose

The purpose of this study is to evaluate the change of mechanical properties and the effect of antibacterial reactions in calcium phosphate cement (CPC) mixed with cefazolin.

Materials and Methods

We made CPC and a sodium alginate solution and we mixed in variable dosages of cefazolin and then we made a standard sized cement mold. With that we performed compression stress tests, drug releasing tests and antibacterial tests.

Results

We found the typical appearance of hydroxyapatite (HA) in the cement mixed with cefazolin. The compressive strength of the cement mixed with cefazolin was higher than that of the cement not mixed with cefazolin and the higher strength cement had a smaller pore size and less porosity. The sodium alginate solution showed the maximum compressive strength at 2 & 4 wt%, but this was decreased at 6 wt%. Cefazolin was released in proportion to the concentration for the first 8 days on the drug releasing test and then a similar amount was released until the tenth day. An antibacterial effect was detected at all dosages of cefazolin on the antibacterial test.

Conclusion

The compressive strength of the cement mixed with cefazolin was higher than that of the cement not mixed with cefazolin. The drug was released from the cement in a proper fashion and the antibacterial effect was preserved.

Figures and Tables

Figure 1
X-ray diffraction patterns of TTCP (A) and α-TCP (B) synthesized by sol-gel process. They showed typical pattern without secondary phase CaO or β-TCP. TTCP, Tetracalcium phophate; α-TCP, α-tricalcium phosphate.
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Figure 2
X-ray diffraction patterns of the cement without (black line) and with cefazolin (gray line). The former showed less HA pattern, but the latter, more HA pattern. HA, hyroxyaptite; TCP, tricalcium phosphate.
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Figure 3
Scanning electron micrographs of hydroxyapatite in the cement without and with cefazolin. The former showed initiation of nucleus formation on the surface and the latter showed a lot of chestnut bur-like appearance of typical hydroxyapatite.
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Figure 4
Change of compressive strength in proportion to concentration of cefazolin. Under 2 wt% sodium alginate, the compressive strength of the cement mixed with cefazolin was higher than that of the cement without cefazolin except when mixed with 5 wt% cefazolin. In particular, the cement contained 10 wt% cefazolin showed the highest compressive strength of 55 MPa.
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Figure 5
Change of the compressive strength in proportion to concentration of sodium alginate. Under 10 wt% cefazolin, it showed the maximum compressive strength at 2 and 4 wt% sodium alginate, but decreased at 6 wt%.
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Figure 6
Results of cefazolin release test. Cefazolin was released in proportion to the concentration for the first 8 days in the drug releasing test and then the similar dosage was released until the tenth day. SD, standard deviation; d, day.
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Figure 7
Photographs of the acting zone of cefazolin at the plate of Staphylococcus aureus ATCC 25923. They showed acting zone by radius at each concentration of cefazolin.
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Figure 8
The histogram of colony forming unit at the culture tube containing cement and Staphylococcus aureus ATCC 25923. Antibacterial effect was detected at all dosages except control group. ATCC, American Tissue Culuture Company; CFU, colony forming unit.
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Table 1
Data of Composition of Control and Experimental Group
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Table 2
The Acting Zone in Proportion to Concentration of Cefazolin at the Plate of Staphylococcus Aureus ATCC 25923
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ATCC, American Tissue Culuture Company.

Table 3
The Colony Forming Unit at the Culture Tube Containing Cement and Staphylococcus Aureus ATCC 25923
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ATCC, American Tissue Culuture Company; CFU, colony forming unit.

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