Antibiotic bone cements have increased in popularity as a complementary treatment to systemically administered antibiotics for
periprosthetic infection. One successful application of antibiotic bone cement is in the 2-stage revision of infected arthroplasties
using antibiotic-loaded spacers, with the advantage of direct antibiotic delivery to the site of infection.
The mechanisms by which the antibiotic is released from the bone cement (PMMA) is still largely undefined. It is believed the
antibiotic is first released directly from the surface and subsequently flows from interconnecting voids and cracks through the
cement rather than by a diffusion process.
Refobacin Plus (Biomet) contains gentamicin and is essentially a high viscosity bone cement, but has an initial low viscosity to
allow for vacuum mixing and adequate delivery
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