Polylactide/polyglycolide antibiotic implants in the treatment of osteomyelitis. A canine model.

Garvin, Kevin L.; Miyano, John; Robinson, Dennis H.; Giger, D K; Novak, Jerzy R.; Radio, Stan.

doi:10.2106/00004623-199410000-00009

Cited by 155 publications

(97 citation statements)

References 24 publications

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“…Several previous in vitro and in vivo studies (1,6,17,25,28,30,32,39) have delineated the use of polymers in different chemistries (polylactides, copolymers of lactide and glycolide, polyanhydrides, and polycaprolactone) as systems for the delivery of various antibiotics. The same composites have uniformly given positive results for the treatment of experimental osteomyelitis (2,8,16,19,29,34,38). Previous studies have mainly focused on antibiotic release from polymer composites during a course of only 1 to 3 months, which is less than the desired optimum for the therapy of treatment-resistant bone infections.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Ciprofloxacin-Releasing Bioabsorbable Osteoconductive Bone Defect Filler for Treatment of Experimental Osteomyelitis Due toStaphylococcus aureus

Koort

Mäkinen

Suokas

et al. 2005

Antimicrob Agents Chemother

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The concept of local antibiotic delivery via biodegradable bone defect fillers with multifunctional properties for the treatment of bone infections is highly appealing. Fillers can be used to obliterate surgical dead space and to provide targeted local bactericidal concentrations in tissue for extended periods. Eventually, the osteoconductive component of the filler could guide the healing of the bone defect. The present experimental study was carried out to test this concept in a localized Staphylococcus aureus osteomyelitis model in the rabbit (n ‫؍‬ 31). A metaphyseal defect of the tibia was filled with a block of bone cement, followed by insertion of a bacterial inoculum. After removal of the bone cement and surgical debridement at 2 weeks, the defect was filled with a ciprofloxacin-containing (7.6% ؎ 0.1%, by weight) composite (treated-infection group) or with a composite without antibiotic (sham-treated group). Both a positive control group (untreated-infection group) and a negative control group were also produced.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Ciprofloxacin-Releasing Bioabsorbable Osteoconductive Bone Defect Filler for Treatment of Experimental Osteomyelitis Due toStaphylococcus aureus

Koort

Mäkinen

Suokas

et al. 2005

Antimicrob Agents Chemother

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“…Various antibiotic-eluting devices and materials have been reported in joint arthroplasty, such as nondegradable materials like spacer beads and polymethylmethacrylate bone cements, titanium implants, [15][16][17] biodegradable materials such as poly-(lactide-co-glycolide) copolymers, [18][19][20] polycaprolactone, 21,22 polyanhydrides, 23,24 polyhydroxybutyrate-co-hydroxyvalerate 25,26 and polyhydroxyalkanoates 27 and natural polymers such as collagen 28,29 and chitosan. 30,31 Titanium and titanium alloys are widely used as orthopedic implants due to their ideal mechanical properties and satisfactory biocompatibility.…”

Section: Introductionmentioning

confidence: 99%

Gentamicin coating of nanotubular anodized titanium implant reduces implant-related osteomyelitis and enhances bone biocompatibility in rabbits

Liu¹,

He²,

Liu³

et al. 2017

IJN

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Titanium and titanium alloy are widely used as orthopedic implants for their favorable mechanical properties and satisfactory biocompatibility. The aim of the present study was to investigate the antibacterial effect and bone cell biocompatibility of a novel implant made with nanotubular anodized titanium coated with gentamicin (NTATi-G) through in vivo study in rabbits. The animals were divided into four groups, each receiving different kinds of implants, that is, NTATi-G, titanium coated with gentamicin (Ti-G), nanotubular anodized titanium uncoated with gentamicin (NTATi) and titanium uncoated with gentamicin (Ti). The results showed that NTATi-G implant prevented implant-related osteomyelitis and enhanced bone biocompatibility in vivo. Moreover, the body temperature of rabbits in NTATi-G and Ti-G groups was lower than those in Ti groups, while the weight of rabbits in NTATi-G and Ti-G groups was heavier than those in NTATi and Ti groups, respectively. White blood cell counts in NTATi-G group were lower than NTATi and Ti groups. Features of myelitis were observed by X-ray films in the NTATi and Ti groups, but not in the NTATi-G and Ti-G groups. The radiographic scores, which assessed pathology and histopathology in bone tissues, were significantly lower in the NTATi-G and Ti-G groups than those in the NTATi and Ti groups, respectively ( P <0.05). Meanwhile, explants and bone tissue culture demonstrated significantly less bacterial growth in the NTATi-G and Ti-G groups than in the NTATi and Ti groups, respectively ( P <0.01). The bone volume in NTATi-G group was greater than Ti-G group, and little bone formation was seen in NTATi and Ti groups.

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“…PLGA and PLA have been used in several studies that have been successful in treating infection (Garvin et al, 1994;Kanellakopoulou et al, 2000;Liu et al, 2002;Koort et al, 2005;Peng et al, 2010;Ambrose et al, 2014), but only a single antibiotic has been tested. The use of hydroxyapatite (Korkusuz et al, 1993;Shinto et al, 1992;Itokazu et al, 1997), calcium phosphate (Nandi et al, 2008) and calcium sulphate (Turner et al, 2005;Parker et al, 2011) in combination with one antibiotic have also been shown to treat infection.…”

Section: Discussionmentioning

confidence: 99%

A biodegradable antibiotic-impregnated scaffold to prevent osteomyelitis in a contaminated in vivo bone defect model

McLaren

White²,

Cox³

et al. 2014

eCM

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Open fractures are at risk of serious infection and, if infected, require several surgical interventions and courses of systemic antibiotics. We investigated a new injectable formulation that simultaneously hardens in vivo to form a porous scaffold for bone repair and delivers antibiotics at high concentrations to the local site of infection. Duration of antimicrobial activity against Staphylococcus aureus was determined using the serial plate transfer test. Ultimate compressive strength and porosity of the material was measured with and without antibiotics. The material was evaluated in vivo in an ovine medial femoral condyle defect model contaminated with S. aureus. Sheep were sacrificed at either 2 or 13 weeks and the defect and surrounding bone assessed using micro-computed tomography and histology. Antimicrobial activity in vitro persisted for 19-21 days. Sheep with antibiotic-free material and bacteria became infected, while those with antibiotic-containing material and bacteria did not. Similarly, new bone growth was seen in uninoculated animals with plain polymer, and in those with antibiotic polymer with bacteria, but not in sheep with plain polymer and bacteria. The antibiotic-impregnated scaffolds were effective in preventing S. aureus infections whilst supporting bone growth and repair. If translated into clinical practice, this approach might reduce the need for systemic antibiotics.

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Polylactide/polyglycolide antibiotic implants in the treatment of osteomyelitis. A canine model.

Cited by 155 publications

References 24 publications

Efficacy of Ciprofloxacin-Releasing Bioabsorbable Osteoconductive Bone Defect Filler for Treatment of Experimental Osteomyelitis Due toStaphylococcus aureus

Efficacy of Ciprofloxacin-Releasing Bioabsorbable Osteoconductive Bone Defect Filler for Treatment of Experimental Osteomyelitis Due toStaphylococcus aureus

Gentamicin coating of nanotubular anodized titanium implant reduces implant-related osteomyelitis and enhances bone biocompatibility in rabbits

A biodegradable antibiotic-impregnated scaffold to prevent osteomyelitis in a contaminated in vivo bone defect model

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