Antibiotic Loaded Acrylic Bone Cement in Orthopaedic Trauma

Local antibiotic delivery with antibiotic loaded acrylic bone cement has been used extensively in the management of chronic osteomyelitis and implant related infections. It is considered the gold standard for treatment of musculoskeletal infections (Nelson, 2004; Hanssen, 2005; Samuel et al., 2010). The critical factors in the treatment of any orthopaedic infection are adequate surgical debridement, integrity of the host immune system, and adequate antibiotic levels (Brien et al., 1993). Antibiotic loaded bone cement (ALBC) is popular as it is a proven way to deliver high concentrations of the drug locally, even to avascular areas that are inaccessible by systemic antibiotics. Another advantage of local antibiotic delivery is that the high concentrations of the drug achieved locally would be effective against organisms that are resistant to drug concentrations achieved by systemic antibiotics. Finally, its use results in only low serum antibiotic concentrations and hence less toxicity than that associated with systemic administration. It is perceived that with future developments local antibiotic delivery systems will likely supplant the traditional use of systemic antibiotics for the treatment of musculoskeletal infections(Hanssen, 2005). This chapter will review the role of antibiotic loaded acrylic bone cement in orthopaedic trauma