Polylactic‐co‐glycolic acid microspheres added to fixative cements and its role on bone infected architecture

Ibarra, Blanca; García-García, J.; Azuara, G.; Vázquez‐Lasa, Blanca; Ortega, Miguel Á.; Asúnsolo, Ángel; Román, Julio San; Buján, Julia; García‐Honduvilla, Natalio; Torre, Basilio de la

doi:10.1002/jbm.b.34342

Cited by 8 publications

(13 citation statements)

References 36 publications

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“…The results indicated that encapsulated ciprofloxacin maintained antibacterial activity after microencapsulation, and that ciprofloxacin-encapsulated PLGA particles yielded a substantial efficacy in inhibiting the growth of bacteria in vivo. Although PLGA holds considerable potential as a carrier for biodegradable drug-delivery systems, 20,21 some noteworthy drawbacks limit its widespread application for treating chronic osteomyelitis. It is difficult to smoothly implant large PLGA particles into the bone marrow cavity due to their high glass-transition temperature and high crystallinity.…”

Section: Introductionmentioning

confidence: 99%

In vitro and in vivo evaluation of a ciprofloxacin delivery system based on poly(DLLA-co-GA-co-CL) for treatment of chronic osteomyelitis

Liu

Bai

Liang

2020

Journal of Applied Biomaterials & Functional Materials

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Chronic osteomyelitis causes serious injury to patients. Antibiotic delivery systems based on poly(lactide-co-glycolide) (PLGA) have great potential for treatment of chronic osteomyelitis. However, PLGA has a glass-transition temperature that is higher than physiological temperatures, resulting in a lack of flexibility for implantation into the bone marrow cavity. As an alternative, poly(d, l-lactide-co-glycolide-co-ε-caprolactone) (PLGC) presents good flexibility due to the introduction of poly(ε-caprolactone) segments. To develop a new strategy for treatment of chronic osteomyelitis, a ciprofloxacin delivery system was prepared using PLGC as carriers, the antibacterial effects of which were evaluated both in vivo and in vitro. The in vitro release behavior showed that the average release reached 268.5 μg/days on day 33, with a cumulative release rate of 56.01%. A bacteriostatic ring, with a diameter of 26.83 ± 0.83 mm, was produced by ciprofloxacin against Staphylococcus aureus after 30 days of release via our ciprofloxacin-PLGC system. After 4 weeks of treatment in vivo, chronic-osteomyelitis-model rats had a bodyweight of 385.83 ± 17.23 g and a normal white-blood-cell count, as well as a lower number of bacterial colonies per gram of bone tissue of (10.6 ± 3.0) × 101 CFU/g. Furthermore, no inflammatory cells were observed via hematoxylin-and-eosin staining, and normal bone structure was observed via X-ray. Taken together, our findings indicate that our novel ciprofloxacin-PLGC system yielded noteworthy antibacterial effects both in vitro and in vivo, suggesting that it may be useful for treating patients with chronic osteomyelitis.

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Section: Introductionmentioning

confidence: 99%

In vitro and in vivo evaluation of a ciprofloxacin delivery system based on poly(DLLA-co-GA-co-CL) for treatment of chronic osteomyelitis

Liu

Bai

Liang

2020

Journal of Applied Biomaterials & Functional Materials

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“…There are widely used histological scales created by different authors [ 14 , 15 ], but they evaluate very specific aspects of the bone histoarchitecture and exhibit great variability depending on the strain of the bacteria, the inoculum, and the selected animal model. For this reason, we developed a new histological staging system that can assess bone tissue in a complete way, providing a global picture of the conservation and remodeling of bone histoarchitecture in the presence of infection and under the influence of bone cement [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Our study group managed to increase the release of vancomycin, daptomycin, and linezolid in vitro, significantly improving the kinetics of their temporary release by incorporating biodegradable microparticles of poly(lactic- co -glycolic acid) (PLGA) in the solid phase of Palacos R cement ® [ 11 ]. Using these developed cements and applying the new histological staging system that we developed [ 16 ], in this paper, we conducted the present study to (1) assess the histological behavior of the modified cement loaded with vancomycin, daptomycin, and/or linezolid in a rabbit model of osteomyelitis; (2) assess the tissue distribution of bacteria; and (3) analyze the presence of macrophages around the different formulations.…”

Section: Introductionmentioning

confidence: 99%

Modification of the Polymer of a Bone Cement with Biodegradable Microspheres of PLGA and Loading with Daptomycin and Vancomycin Improve the Response to Bone Tissue Infection

et al. 2022

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Chronic infections are one of the most serious adverse outcomes of prosthetic surgery. Prosthetic revision surgery using a bone cement loaded with antibiotics between the two stages of the surgery is commonly performed. However, this method often fails to reach the minimum inhibitory concentration and promotes antibiotic resistance, thus emphasizing the need for improving the current available therapies. Materials and methods: In this study, we performed a study of the in vivo response of a polymer-based construct of poly (lactic-co-glycolic acid) (PLGA) in the solid phase of Palacos R® in combination with vancomycin, daptomycin, and/or linezolid. To test its effectiveness, we applied an in vivo model, using both histological and immunohistochemical analyses to study the bone tissue. Results: The presence of PLGA in the combination of vancomycin with daptomycin showed the most promising results regarding the preservation of bone cytoarchitecture and S. aureus elimination. Conversely, the combination of vancomycin plus linezolid was associated with a loss of bone cytoarchitecture, probably related to an increased macrophage response and inefficient antimicrobial activity. Conclusions: The modification of Palacos R® bone cement with PLGA microspheres and its doping with the antibiotic daptomycin in combination with vancomycin improve the tissue response to bone infection.

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“…Total knee arthroplasty (TKA) is the definitive treatment for knee osteoarthritis (OA), reducing pain and providing a better quality of life [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. However, 15 to 30% of the patients that undergo TKA, show little or no improvement after surgery [ 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis

Peña

Ortega

Buján

et al. 2021

IJERPH

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The outcome in total knee arthroplasty (TKA) depends on multiples factors, among them is the psychological condition. In addition, up 15 to 30% of the patients that undergo TKA show little or no improvement after surgery, which implies the diagnosis of a painful TKA is a challenge for the orthopedic surgeon, who must rule out a possible metal allergy (MA). It is considered an exclusion diagnosis. Due to the complex relationship between psychological condition and MA, and according to the worse results in patients treated with a hypoallergenic TKA, we asked: (1). What degree of psychological distress (PD) is present in patients who have a hypoallergenic TKA, and how does it influence the results of quality of life (QoL) and functional capacity. (2). Can we develop a new algorithm for patients with a possible MA that improves the outcomes? A pragmatic clinical study was carried out that included patients who underwent hypoallergenic TKA during three consecutive years. Quality of life and functional capacity were measured with (Western Ontario McMaster Universities Osteoarthritis Index) WOMAC index, the Short Form 12 questionnaire (SF-12) questionnaire, and the The EQ-5D-5L questionnaire essentially consists of two pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS) (Euro-QoL-5D L-VAS (EQ5D)), in all patients. To assess PD, a Psychological Distress Score was developed. SPSS software was performed to statistical analysis, and Student´s test for independent variables with a p < 0.005 as statistically significant. A total of 72 anallergic TKAs in 64 patients were treated during this period; 31.3% of these patients showed features of PD before the surgery. According with the severity of the PD, 60% were classified as severe, 10% as moderate and 30% as mild. Patients with PD had statistically significant worse results on the final WOMAC, SF-12, and EQ5D questionnaires. The final scores of the physical subscale of the SF-12 and EQ5D showed better results in patients diagnosed by psychiatrist. Up to one third of the patients with hypoallergenic TKAs have PD, and their results are clearly inferior to those patients with MA without PD. When PD was diagnosed according with Psychological Distress Score, patients should be carefully assessed in order to determine if a specialist referral is recommended. According with our results, PD should be assessed either by the PCP or by us. If the PD is confirmed, a psychiatry referral is then requested for better preoperative management and treatment. We believe that this approach would lead to better TKA outcomes.

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Polylactic‐co‐glycolic acid microspheres added to fixative cements and its role on bone infected architecture

Cited by 8 publications

References 36 publications

In vitro and in vivo evaluation of a ciprofloxacin delivery system based on poly(DLLA-co-GA-co-CL) for treatment of chronic osteomyelitis

In vitro and in vivo evaluation of a ciprofloxacin delivery system based on poly(DLLA-co-GA-co-CL) for treatment of chronic osteomyelitis

Modification of the Polymer of a Bone Cement with Biodegradable Microspheres of PLGA and Loading with Daptomycin and Vancomycin Improve the Response to Bone Tissue Infection

Influence of Psychological Distress in Patients with Hypoallergenic Total Knee Arthroplasty. Treatment Algorithm for Patients with Metal Allergy and Knee Osteoarthritis

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