Enhancing orthopedic outcomes: A comparative analysis of gentamicin sulphate and nanosilver in bone cement

Abstract

Background: Orthopedic surgeries frequently utilize bone cement, which can increase the risk of postoperative infections. Addressing this challenge, this study aims to enhance the mechanical, physical, and handling properties of bone cement by integrating gentamicin sulfate (GS) and nanosilver (nAg). The objective is to evaluate and compare the effects of these additives on properties such as compressive strength, flexural strength, doughing time, working time, setting time, and exothermic temperature. By doing so, the study seeks to identify a safer and more effective alternative to traditional antibiotics in bone cement formulations, thereby improving clinical outcomes in orthopedic procedures. Methods: This research involved a comparative analysis of modified cements against standard cements, focusing on compressive strength, flexural strength, doughing time, working time, setting time, and exothermic temperature. Various bone cement samples with GS and nAg additives were prepared and tested in accordance with international standards (ISO 5833:2002 and ASTM F451). Statistical analysis, including one-way and twoway ANOVA tests, was used to assess the significance of the results. Results: nAg-loaded cements exhibit mechanical and physical properties on par with or supe-rior to those of GS-loaded and standard cements. Notably, nAg incorporation leads to significantly lower exothermic temperatures, reducing the risk of thermal bone tissue damage. This finding highlights that nAg-loaded cement is a safer alternative. Alongside unaltered or enhanced strength, nAgs demonstrate promise for orthopedic applications, particularly in primary arthroplasty. Additionally, nAgs reduce doughing time, enhancing the practicality of these methods in surgical settings. Conclusions: In conclusion, this study underscores the potential advantages of incorporating GSs and nAgs into bone cement. nAg-loaded cement offers improved properties and reduced infection risk, making it a valuable choice for orthopedic procedures. It enhances both mechanical performance and safety, addressing crucial concerns in orthopedic surgery.