Antibiotic-Impregnated Bone Grafts in Orthopaedic and Trauma Surgery: A Systematic Review of the Literature

Table 1

Literature review about antibiotic-impregnated bone grafts with specific attention on types of bone graft, antibiotics, and impregnation details.

Study	Publication year	In vitro/animal/in vivo	Bone graft	Antibiotic(s)	Antibiotic/bone graft ratio	Impregnation method	Duration of antibiotic impregnation
Allende et al. [8]	2010	In vivo	Cancellous/; corticocancellous	Vancomycin	1.5 g/case	n.r.	n.r.
Borkhuu et al. [9]	2008	In vivo	Corticocancellous	Gentamicin	8–10 mg/kg patient/30–60 cc	Solution	n.r.
Buttaro et al. [10]	2003	Animal	Cancellous	Vancomycin	20 mg/6 g	Manual mixing	15 min
Buttaro et al. [11]	2005	In vivo	Cancellous	Vancomycin	1 g/femoral head	Manual mixing	15 min
Buttaro et al. [12]	2005	In vivo	Cancellous	Vancomycin	0.5 g/femoral head	Manual mixing	15 min
Buttaro et al. [13]	2005	In vivo	Cancellous	Vancomycin	1 g/femoral head	Manual mixing	15 min
Chan et al. [14]	1998	In vivo	Cancellous	Vancomycin; piperacillin	n.r.	Manual mixing	n.r.
Chan et al. [15]	2000	In vivo	Cancellous	Vancomycin; piperacillin	n.r.	Manual mixing	n.r.
Chen et al. [16]	2005	In vivo	Cancellous	Vancomycin	0.5 g/16 g	Manual mixing	n.r.
Day et al. [17]	2005	In vitro	Cortical	Gentamicin; flucloxacillin	1% solution of each antibiotic/graft	Iontophoresis	1/5/10 min
English et al. [18]	2002	In vivo	Cancellous	Gentamicin; vancomycin; flucloxacillin	n.r.	n.r.	n.r.
Gray and Elves [19]	1981	Animal	Corticocancellous	Benzylpenicillin; streptomycin	800,000 units/L/n.r.	Solution	n.r.
					500 mg/L/n.r.
Kanellakopoulou et al. [20]	2008	In vitro	Cancellous	Fusidic acid; teicoplanin	100 mg/mL	Solution	60 min
Kanellakopoulou et al. [21]	2010	In vitro	Cancellous	Moxifloxacin	500 mg/1 g	Solution	n.r.
Ketonis et al. [22]	2010	In vitro	Corticocancellous	Vancomycin	10 mg/mL	Solution	12–16 h
Ketonis et al. [23]	2010	In vitro	Cortical; morselized	Vancomycin	10 mg/mL	Solution	n.r.
Khoo et al. [24]	2006	In vivo	Segmental allograft	Gentamicin; flucloxacillin	1% gentamicin solution/graft; 4% flucloxacillin solution/graft	Iontophoresis	20 min
Lindsey et al. [25]	1993	Animal	Cancellous	Tobramycin	90 mg/3 g	Manual mixing	n.r.
					0.5 μg/10 μL
					2.5 μg/10 μL
				Cefazolin	10 μg/10 μL
					60 μg/10 μL
Mathijssen et al. [26]	2010	In vitro	Cancellous		100 μg/10 μL	Solution	n.r.
					0.5 μg/10 μL
					2.5 μg/10 μL
				Vancomycin	10 μg/10 μL
					70 μg/10 μL
					100 μg/10 μL
McLaren [7]	1989	In vivo	Cancellous	Vancomycin; tobramycin	1 g/>20 g; 720 mg/>20 g	Manual mixing	n.r.
Michalak et al. [27]	2006	In vivo	Segmental allograft	Gentamicin; flucloxacillin	1% gentamicin solution/graft; 4% flucloxacillin solution/graft	Iontophoresis	20 min
Miclau et al. [28]	1993	In vitro	Cancellous	Tobramycin	25 mg/g	Manual mixing	n.r.
Petri [29]	1984	Animal	Bone-gelatin powder	Cephalothin; tobramycin	100–200 μg/mL b-g powder; 1-2 mg/mL b-g-powder	Manual mixing	n.r.
Petri and Schaberg [30]	1984	Animal	Bone-gelatin powder	Cephalothin; tobramycin	200 μg/mL b-g powder; 2 mg/mL b-g powder	Manual mixing	n.r.
Petri [31]	1991	Animal	Bone-gelatin powder	Cephalothin; tobramycin	1 mg/mL b-g powder; 1 mg/mL b-g powder	Manual mixing	n.r.
Rhyu et al. [32]	2003	In vitro	Cancellous	Vancomycin	125 mg/mL/66–70 mg	Solution	24 h
Seber et al. [33]	1998	In vivo	Xenograft	Gentamicin	25 mg/125 cc	Solution	8 h
Winkler et al. [34]	2000	In vitro	Cancellous; cortical	Vancomycin; tobramycin	100 mg/mL/block; 80 mg/mL/block	Solution	24 h
Winkler et al. [35]	2006	In vivo	Cancellous	Vancomycin; tobramycin	100 mg/cc; 75 mg/cc	Solution	24 h
Winkler et al. [36]	2008	In vivo	Cancellous	Vancomycin; tobramycin	100 mg/cc; 75 mg/cc	Solution	24 h
Witsø et al. [37]	1999	In vitro	Cancellous	Benzylpenicillin; dicloxacillin; cephalothin; netilmicin; vancomycin; clindamycin; ciprofloxacin; rifampicin	100 mg/mL/g; 100 mg/mL/g; 100 mg/mL/g; 100 mg/mL/g; 50 mg/mL/g; 150 mg/mL/g; 2 mg/mL/g; 60 mg/mL/g	Solution	10 min
Witsø et al. [38]	2000	In vitro/animal	Cancellous	Benzylpenicillin; cephalothin; clindamycin; netilmicin; vancomycin; ciprofloxacin; rifampicin	100 mg/mL/g; 100 mg/mL/g; 150 mg/mL/g; 100 mg/mL/g; 50 mg/mL/g; 2 mg/mL/g; 60 mg/mL/g	Solution	10 min
Witsø et al. [39]	2002	In vitro/animal	Cancellous	Netilmicin; vancomycin	100 mg/mL/g; 100 mg/mL/g	Solution	10 min
Witsø et al. [40]	2004	In vivo	Cancellous	Netilmicin	50/100 mg/mL/50 g	Solution	10 min
Witsø et al. [41]	2005	In vitro	Cortical	Netilmicin; vancomycin; ciprofloxacin; rifampicin	400 mg/mL/1.46 g; 100 mg/mL/1.46 g; 2 mg/mL/1.46 g; 50 mg/mL/1.46 g	Solution	1/10/100 h

n.r.: not reported.