Radical scavenging of poly(methyl methacrylate) bone cement by rifampin and clinically relevant properties of the rifampin-loaded cement.

OBJECTIVES: The objective of this study was to characterize the effect of rifampin incorporation into poly(methyl methacrylate) (PMMA) bone cement. While incompatibilities between the two materials have been previously noted, we sought to identify and quantify the cause of rifampin's effects, including alterations in curing properties, mechanical strength, and residual monomer content. METHODS: Four cement groups were prepared using commercial PMMA bone cement: a control; one with 1 g of rifampin; and one each with equimolar amounts of ascorbic acid or hydroquinone relative to the amount of rifampin added. The handling properties, setting time, exothermic output, and monomer loss were measured throughout curing. The mechanical strength of each group was tested over 14 days. A radical scavenging assay was used to assess the scavenging abilities of rifampin and its individual moieties. RESULTS: Compared with control, the rifampin-incorporated cement had a prolonged setting time and a reduction in exothermic output during polymerization. The rifampin cement showed significantly reduced strength and was below the orthopaedic weight-bearing threshold of 70 MPa. Based on the radical scavenging assay and strength tests, the hydroquinone structure within rifampin was identified as the polymerization inhibitor. CONCLUSION: The incorporation of rifampin into PMMA bone cement interferes with the cement's radical polymerization. This interference is due to the hydroquinone moiety within rifampin. This combination alters the cement's handling and curing properties, and lowers the strength below the threshold for weight-bearing applications. Additionally, the incomplete polymerization leads to increased toxic monomer output, which discourages its use even in non-weight-bearing applications.Cite this article: G. A. Funk, E. M. Menuey, K. A. Cole, T. P. Schuman, K. V. Kilway, T. E. McIff. Radical scavenging of poly(methyl methacrylate) bone cement by rifampin and clinically relevant properties of the rifampin-loaded cement. Bone Joint Res 2019;8:81-89. DOI: 10.1302/2046-3758.82.BJR-2018-0170.R2.

Protein-rejecting ability of surface-bound dextran in end-on and side-on configurations: comparison to PEG.

There is much interest in attaching polyethylene glycol (PEG) and other hydrophilic, neutral polymers to surfaces to reduce the extent of protein and cell adsorption. Interestingly, these same surface-bound polymers are effective in masking surface charge and reducing electrokinetic effects such as particle electrophoretic mobility, streaming potential, and electroosmosis. It is apparent that similar molecular properties are responsible for both protein and cell rejection and reduction of electrokinetic effects. In this work we compared the fibrinogen-rejecting ability and the effect on electrophoretic mobility of three polymer coatings bound to polystyrene. The three polymers were side-bound dextran, end-bound dextran, and end-bound PEG. The results of these measurements were used to elucidate the importance of polymer packing density and polymer layer thickness on protein adsorption and reduction of electrokinetic effects. Protein adsorption appears not to be sensitive to polymer layer thickness or the presence of dilute polymer tails in a surface coating, while electrokinetic effects are. Protein adsorption is, however, very sensitive to the availability of exposed surface. Finally, the unique effectiveness of PEG is apparent in this research as in previous studies.

Effects of branching and molecular weight of surface-bound poly(ethylene oxide) on protein rejection.

To understand better the origin of protein rejection observed with surface-bound poly(ethylene oxide) (or PEO), we have measured fibrinogen adsorption for a series of linear and branched, low-molecular-weight PEOs bound to solid polystyrene surfaces. The results show that a dependence on molecular weight is found below 1500 g mol-1 for linear PEO. Branched PEOs are less effective at protein rejection than linear PEOs. The branched PEOs have smaller exclusion volumes (from GPC) than the corresponding linear PEOs, consistent with restriction in conformational freedom for the branched compounds. The protein rejection results are interpreted in terms of entropy changes that result upon protein adsorption. In addition, some practical problems in preparation of PEO glycidyl ethers have been clarified, thus making these PEO derivatives more useful for surface modification.