A biodegradable gentamicin-hydroxyapatite-coating for infection prophylaxis in cementless hip prostheses

Neut, Daniëlle; Dijkstra, René J. B.; Thompson, Jonathan; Kavanagh, C.; Mei, H. C. van der; Busscher, Henk J.

doi:10.22203/ecm.v029a04

Cited by 67 publications

(37 citation statements)

References 50 publications

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“…However, the unknown long-term, questionable large- scale applicability, and the complex regulatory pathway still limit this technology. Biodegradable polymers and sol-gel coatings have been shown to provide controlled antibiotic release on titanium 47, 48 or hydroxyapatite implants 49, offering ease of use, versatility, and possible large-scale application. In the present application, the anti-adhesive ability of the DAC hydrogel has been coupled to local antibiotic administration, to reduce the chance for planktonic bacteria to colonize the implant.…”

Section: Discussionmentioning

confidence: 99%

Does an Antibiotic-Loaded Hydrogel Coating Reduce Early Post-Surgical Infection After Joint Arthroplasty?

Cl¹,

Malizos

Capuano³

et al. 2016

J. Bone Joint Infect.

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Background: Infection remains among the main reasons for joint prosthesis failure. Preclinical reports have suggested that antibacterial coatings of implants may prevent bacterial adhesion and biofilm formation. This study presents the results of the first clinical trial on an antibiotic-loaded fast-resorbable hydrogel coating (Defensive Antibacterial Coating, DAC®) in patients undergoing hip or knee prosthesis.Methods: In this multicenter, randomized prospective study, a total of 380 patients, scheduled to undergo primary (n=270) or revision (n=110) total hip (N=298) or knee (N=82) joint replacement with a cementless or a hybrid implant, were randomly assigned, in six European orthopedic centers, to receive an implant either with the antibiotic-loaded DAC coating (treatment group) or without coating (control group). Pre- and postoperative assessment of clinical scores, wound healing, laboratory tests, and x-ray exams were performed at fixed time intervals.Results: Overall, 373 patients were available at a mean follow-up of 14.5 ± 5.5 months (range 6 to 24). On average, wound healing, laboratory and radiographic findings showed no significant difference between the two groups. Eleven early surgical site infections were observed in the control group and only one in the treatment group (6% vs. 0.6%; p=0.003). No local or systemic side effects related to the DAC hydrogel coating were observed, and no detectable interference with implant osteointegration was noted.Conclusions: The use of a fast-resorbable, antibiotic-loaded hydrogel implant coating can reduce the rate of early surgical site infections, without any detectable adverse events or side effects after hip or knee joint replacement with a cementless or hybrid implant.

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Section: Discussionmentioning

confidence: 99%

Does an Antibiotic-Loaded Hydrogel Coating Reduce Early Post-Surgical Infection After Joint Arthroplasty?

Cl¹,

Malizos

Capuano³

et al. 2016

J. Bone Joint Infect.

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“…In more recent years, grit‐blasted and mesoporous materials, such as hydroxyapatite (HA), have been also loaded with gentamicin and tobramycin . The release and efficacy of vancomycin hydrochloride, cephalothin sodium, amoxicillin and carbenicillin sodium salts have been also tested when incorporated in HA coatings .…”

Section: Antimicrobial Coatingsmentioning

confidence: 99%

Antifouling and antimicrobial biomaterials: an overview

Francolini

Vuotto

Piozzi

et al. 2017

APMIS

264

220

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The use of implantable medical devices is a common and indispensable part of medical care for both diagnostic and therapeutic purposes. However, as side effect, the implant of medical devices quite often leads to the occurrence of difficult‐to‐treat infections, as a consequence of the colonization of their abiotic surfaces by biofilm‐growing microorganisms increasingly resistant to antimicrobial therapies. A promising strategy to combat device‐related infections is based on anti‐infective biomaterials that either repel microbes, so they cannot attach to the device surfaces, or kill them in the surrounding areas. In general, such biomaterials are characterized by antifouling coatings, exhibiting low adhesion or even repellent properties towards microorganisms, or antimicrobial coatings, able to kill microbes approaching the surface. In this light, the present overview will address the development in the last two decades of antifouling and antimicrobial biomaterials designed to potentially limit the initial stages of microbial adhesion, as well as the microbial growth and biofilm formation on medical device surfaces.

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“…Additions of bone morphogenetic proteins and growth factors [568], mesenchymal stem cells [603], and therapeutic genes [604] have also been explored for similar reasons. Elutable silver [605,606] or antibiotics [607,608] have been incorporated to inhibit nosocomial infections. Composites of synthetic bio-erodible polymers [609] (e.g., polylactic acid, polyglycolic acid, and polylactic-co-glycolide), natural occurring polymers [610][611][612] (e.g., alginate, collagen, chitosan), or nonresorbing polyurethane [613] have been constructed principally to improve mechanical properties.…”

Section: Bioactive and Resorbable Ceramicsmentioning

confidence: 99%