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The elution of antibiotics from the bone cement does not necessarily reflect the tissue concentrations.
Moreover, the evidence shows that even repeated mixing of PMMA bone cement does not pose an additional risk to operative theatres' personnel [ 105].
This indicates that the enrichment of bone cement with bisphosphonate in ratio of 40 g of bone cement to 60 mg of BP-enriched bone cement does not cause any visible changes in the chemical composite of bone cement.
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In vitro experiments demonstrated the CSH/APVA-PM bone cement did not show cytotoxicity and the porous structure allowed the rat bone marrow stem cells (BMSCs) to grow into the pores.
Implantation of pamidronate into the bone cement did not change chemical properties also.
In the presented data, we conclude that the implantation of pamidronate into bone cement did not aggravate its biomechanical properties.
Others proved that even large amount of antibiotics implanted into bone cement did not adversely affect its mechanical properties [ 19].
The prolonged release of antibiotics from antibiotic-containing bone cement did not protect against late hematogenous infections[ 28].
In the present study, Cemex bone cement did not show inferior fixation capabilities compared to Palacos up to 10 years postoperatively.
In the presented data, we conclude that use of pamidronate implanted in bone cement did not have a detrimental effect on its biomechanical properties.
This is the case, for example, in classical Buchholz's work, where the antibiotic placed in the bone cement did not necessarily correlate with the culture-based sensitivity of the organisms [ 65].
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